J.Jpn. Surg. Soc.. 81(4): 299-305, 1980

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Original article

TACHNECL AND POSITOPERATIVE PROBLEMS IN SLEEVE LOBECTOMY FOR LUNG CANCER

Twenty-four lung cancer patients who underwent lobectomy with bronchial reconstruction (sleeve lobectomy) were reviewed from the view points of technical and postoperative problems. Six in the 24 patients died within 2 years and 10 months postoperatively, 4 out of 6 cases succumbed of tumor recurrence. Of the 4 patients 3 had pulmonary arterial reconstruction during sleeve lobectomy.
Pulmonary complications early after surgery including retained bronchial secretion, atelectasis, pneumonia and wet lung occured in 8 patients. Air leak and bronchial bleeding were other early postoperative complications. Late complications were stenosis and tumor recurrence around the anastomotic site, and the former was observed in 3 cases and the latter occured in one advanced case.
Bronchoscopic findings of patients with sleeve lobectomy after one month or more postoperatively showed that such anastomotic technique was essential to prevent postoperative granulation tissue or scar formation as placing all the sutures outside the bornchial lumen.
Lung function tests by bronchospirometry or 99mTc-MAA perfusion scanning indicated the sufficient function at operated side from the immediate postoperative period, even in the patient with sleeve lobectomy in which the pulmonary arterial reconstruction had been carried out.

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