J.Jpn. Surg. Soc.. 80(11): 1215-1219, 1979

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Report on the annual meeting

TRACHEAL AND BRONCHIAL PLASTIC SURGERY

Tracheobronchial plastic surgery was performed in 52 patients from April, 1959 to March, 1979. In 17 patients, tracheal surgery was carried out, employing the procedures such as permanent tracheostomy in the mediastinum, sleeve resection and patch grafting with pericardium or diaphragm. The prognosis of the patients with malignant lesions was generally poor because of extensive invasion and a high incidence of postoperative mortality and complications.
However sleeve resection was the most feasible indication for posttracheostomy stenosis and tracheal epidermoid carcinoma. Bronchial plastic procedure has been done in 30 patients with lung cancer, 3 with tuberculous stenosis, 2 with bronchial adenoma and 1 with bronchial rupture. This procedure has been applicable for lung cancer because of direct cancerous or metastatic nodal invasion to the proximal bronchus. In the pathological study of bronchial extension, epidermoid carcinoma, most frequent cell type to be present in 20 cases, has shown the mode of direct invasion with all kinds of mucosal, submucosal or adventitial extension, whereas 6 cases with adenocarcinoma which underwent this technique had a tendency to submucosal or adventitial extension from the metastatic nodes. It is emphasized that bronchial transection should be made with a margin of 2.0 cm or more beyond visible carcinoma for adequate clearance.
There was no significant difference of survival curve between the patients with standard lebectomy and those of lobectomy with bronchoplastic procedure for lung cancer.

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