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Titolo:
Complications of tracheal sleeve pneumonectomy: Personal experience and overview of the literature
Autore:
Roviaro, G; Varoli, F; Romanelli, A; Vergani, C; Maciocco, M;
Indirizzi:
San Giuseppe Hosp FbF, Dept Gen Surg, I-20122 Milan, Italy San Giuseppe Hosp FbF Milan Italy I-20122 Gen Surg, I-20122 Milan, Italy
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 2, volume: 121, anno: 2001,
pagine: 234 - 240
SICI:
0022-5223(200102)121:2<234:COTSPP>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSTPNEUMONECTOMY PULMONARY-EDEMA; BRONCHOGENIC-CARCINOMA; BRONCHOPLASTIC PROCEDURES; LUNG-CANCER; RESECTION; MORTALITY; CARINA; SURVIVAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Roviaro, G San Giuseppe Hosp FbF, Dept Gen Surg, Via San Vittore 12, I-20122 Milan, Italy San Giuseppe Hosp FbF Via San Vittore 12 Milan Italy I-20122 y
Citazione:
G. Roviaro et al., "Complications of tracheal sleeve pneumonectomy: Personal experience and overview of the literature", J THOR SURG, 121(2), 2001, pp. 234-240

Abstract

Objectives: Tracheal sleeve pneumonectomy, although technically demanding,is considered the choice for tracheobronchial angle cancers. Complicationsin our 49 tracheal sleeve pneumonectomies are reviewed. Results, complications, and technical aspects are critically discussed. Although series in the literature differ in selection of patients and surgical techniques and extend over long periods, we attempt to compare our experience with results from the literature. Methods: From 1983 to September 1999, 60 patients eligible for tracheal sleeve pneumonectomy after conventional staging underwent operation. A Sybilla Fome-Cuf ventilation tube (Bivona, Inc, Gary, Ind) was used starting in 1987 to facilitate anastomosis. Since 1993, all patients have undergone video-assisted thoracoscopy immediately before the operation. Results: There were 11 (18.3%) exploratory thoracotomies, 48 right tracheal sleeve pneumonectomies, and 1 left tracheal sleeve pneumonectomy. Among the tracheal sleeve pneumonectomies, we recorded 4 (8.2%) perioperative deaths (myocardial infarction, n = 1; heart failure, n = 1; pulmonary edema, n = I; gastric ulcer hemorrhage, n = 1; and anastomotic fistula in a patient who received high-dose radiation before the operation, n = 1). We observed 5 (10.2%) complications (lung edema, n = I; transitory recurrent nerve palsy, n = 2; empyema without fistula cured conservatively, n = 1; and pneumonia, n = I). Anastomotic stenosis did not occur. Twenty-six (53%) patients are alive 14 to 87 months postoperatively, 12 (24.5%) of these more than 5 years postoperatively. Five (10.2%) died of mediastinal recurrence at 6 and 54 months. Two others (4.1%) died in road accidents. Conclusions: Tracheal sleeve pneumonectomy is a demanding operation with ahigh risk of complications. Analysis of literature and personal experienceshows that complications can be greatly reduced through accurate selectionof patients, precise technique, and optimal postoperative care. Long-term survival equals that obtained after standard pneumonectomy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 12:19:20