Maurizi G, et al. - Researchers, in this study, presented their experience and results in relation to reimplantation of the upper lobe bronchus after lower sleeve lobectomy or bilobectomy (the so-called Y-sleeve resection). They identified this procedure as technically feasible and oncologically adequate.

Methods

• From 1989 to 2015, 28 Y-sleeve resections of the left lower lobe (n = 18) or right middle and lower lobes (n = 10) were performed.
• Researchers performed the lung-sparing reconstructive operation for non-small-cell lung cancer in 23 cases, for bronchial carcinoid tumour in 4 cases and for a cystic adenoid carcinoma in 1 case.
• They performed anastomotic reconstruction by interrupted 4-0 absorbable sutures (monofilament material).

Results

• Complete (R0) resections were performed in all patients.
• Researchers observed a postoperative mortality of 3.6%.
• Major complication rate of 10.7% was evident (1 myocardial infarction, 1 anastomotic stenosis requiring dilatation and 1 anastomotic fistula).
• They identified Stage I in 8 patients, Stage II in 9 and Stage IIIa in 6 among the 23 patients with non-small-cell lung cancer (18 men and 5 women; mean age 58 ± 12 years).
• Recurrence rate of 32% was noticed at a mean follow-up of 46 months.
• Two loco-regional recurrences were reported.
• They identified no report of endobronchial or perianastomotic recurrence.
• In this study, the 3- and 5-year overall and disease-free survival rates of patients with non-small-cell lung cancer were 76.3% and 55.1% and 68.7% and 62.9%, respectively.