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The Journal of Thoracic and Cardiovascular Surgery, Vol 90, 161-166, Copyright © 1985 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
S Fujimura, T Kondo, T Imai, A Yamauchi, M Handa, T Okabe and T Nakada
Fifty-two patients have undergone tracheobronchial reconstruction for
bronchogenic carcinomas over a 20 year period and have been evaluated from
the view point of prognosis. Five-year survival rates of the patients
undergoing reconstructive operations were as follows: 35% for the total
group, 50% for those with squamous cell carcinoma, and 64% for those with
Stage I and II disease. No patients with adenocarcinoma or Stage III
disease have survived more than 5 years. However, the number of patients
with early adenocarcinoma was too small for us to conclude that the
histologic type per se affected survival. Six of eight patients with sleeve
lobectomy and pulmonary artery reconstruction died within 2 years, 7 months
postoperatively. Five of seven patients died within 1 year after carinal
reconstruction. However, two are alive at 4 months and 2 years, 9 months
after left or right sleeve pneumonectomy. In summary, any types of
lobectomy or pneumonectomy with reconstruction of the tracheobronchial tree
can be conducted in patients with Stage I and II lung cancer. Sleeve
lobectomy with pulmonary artery reconstruction can be an alternative to
pneumonectomy when pneumonectomy is contraindicated because of low
cardiopulmonary reserve. In patients undergoing reconstruction of the
carina, prophylactic radiation therapy may be necessary during the
postoperative course.
ARTICLES
Prognostic evaluation of tracheobronchial reconstruction for bronchogenic carcinoma
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