Bronchoplasty for primary broncho-pulmonary tumors

الملخص EN

Background : Parenchyma-sparing procedures are widely used in patients with low-grade malignancies of the airway when anatomically suited lesions exist.

This study was conducted to evaluate the short-term and the long-term results of bronchoplastic procedures for patients with centrally located primary bronchopulmonary tumors.

Methods : between 2000 and 2009, 36 patients with primary lung tumors required bronchoplasty were retrospectively analyzed.

Preoperative assessment included computed tomography (CT) of the chest, bronchoscopy, and spirometer.

Pre-operative diagnosis was achieved by bronchoscopy for all patients, mediastinoscopy was done for patients with primary lung cancer.

Neo adjuvant chemotherapy was given for 6 patients with non-small cell lung cancer (NSCLC).

Results : we had 15 males and 21 female, the mean age was 37 years and the mean hospital stay was 7.2 days.

Operative procedures performed were : sleeve lobectomy in 30 patients (13 right, 17 left), partial sleeve right pneumonectomy in 3 and bronchial resection with anastomosis in 3 (2 left, 1 right).

Twelve patients (33.3 %) suffered post-operative problems.

There was One operative related mortality.

Post-operative pathology revealed: 27 patients with typical carcinoid, 2 with atypical carcinoid, 4 with squamous cell carcinoma, 2 with adenocarcinoma and one with hematoma.

Pathological TNM staging revealed: 17 patients with stage IA, 11 with IB, 5 with IIA and 2 with stage IIIA.

Follow-up data were available for all patients except two.

Two patients died with disseminated disease 1.5 year and 2 years after surgery.

The patient with hematoma developed local recurrence 5 years later and re-excision was done.

One patient with lung cancer developed bone metastases and was alive with disease, while the remaining 30 patients were alive and disease free.

The overall 5 years survival was 83.3 % Conclusion : Bronchoplastic resections achieve local control and long-term survival comparable to the standard resections in patients with carcinoid tumor and NSCLC in anatomically suited lesions.