ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
SLEEVE RESECTIONS: TECHNIQUES OF ANASTOMOSES, MORBIDITY, MORTALITY
Muzaffer METİN, Adnan SAYAR, Adalet DEMİR, Cemal Asım Kutlu, Akif Turna, Aysun Ölçmen, Okan Solak, Atilla Gürses
Yedikule Göğüs Hastalıkarı ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, İstanbul
Background: Sleeve lobectomy, resulting considerably low mortality, morbidity, comparable survival and remaining more pulmonary parenchyma, has been an alternative surgical procedure to pneumonectomy in technically suitable cases. We aimed to evaluate the morbidity, mortality in our resected non-small cell lung cancer patients who had sleeve lobectomy.

Methods: From January 1993 to June 2000, 15 patients (14 male and 1 female) underwent sleeve lobectomy for lung tumors. The mean age was 42 years (23 to 66 years). Predicted postoperative lung functions of all patients were calculated to be adequate for pneumonectomy (FEV1 > 2000 ml). Eight cases had right-sided, other 7 had left-sided tumors. The histological type was predominantly epidermoid in 10 cases, followed by adenocarcinoma in 3 and carcinoid tumor in 2 cases. In seven cases we perform end to end anostomoses with seperated suture, and in 8 cases with a continues suture. One patient required a concomitant sleeve resection of pulmonary artery (double sleeve resection). Anastomosis was enforced with parietal pleura in 11 cases, pericardial fat pad in 2 cases and intercostal muscle flap in 2 cases.

Results: The operative mortality was 12% (n = 2). Anastomosis was performerd using interrupted polyglactin sutures in all of two patients. One patient required completion pneumonectomy after postoperative bronchial stenosis was developed in third postoperative month. One patient was discharged home with persistent aseptic loculated space. No patients were lost to follow-up. The mean follow-up time was 36 months (2 to 84 months). No recurrence occurred in patients.

Conclusions: Sleeve lobectomy can be used as an alternative to pneumonectomy in selected cases and has low morbidity. Despite the relatively high mortality rate, recent sleeve lobectomies performed in last two years resulted with no mortality and morbidity. Sleeve lobectomy can be an alternative procedure to pneumonectomy.

Keywords : Sleeve resection, pneumonectomy
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