Thorac cardiovasc Surg
DOI: 10.1055/s-0038-1642597
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Is Right Sleeve Lower Lobectomy Necessary? Is It Safe?

Celalettin Ibrahim Kocaturk
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Ozkan Saydam
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Celal Bugra Sezen
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Cem Emrah Kalafat
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Levent Cansever
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Ali Cevat Kutluk
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Hasan Akin
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
,
Muzaffer Metin
1  Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey
› Author Affiliations
Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.
Further Information

Publication History

13 December 2017

01 March 2018

Publication Date:
23 May 2018 (online)

Abstract

Objectives The right sleeve lower lobectomy is the least used of the bronchial sleeve operations. There are only case-based studies in the literature. In this study, we compared this technique to those used in patients who underwent a right lower bilobectomy.

Methods We retrospectively reviewed the data of patients who had been operated on due to non-small cell lung cancer (NSCLC) from January 2005 to December 2015 from a dataset that was formed prospectively. Of the 4,166 patients who underwent resections due to NSCLC, the files of those who had a right sleeve lower lobectomy (group S) and those who had a right lower bilobectomy (group B) were evaluated. The remaining 25 patients in group B and 18 patients in group S were compared in terms of demographic data, morbidity, hospitalization time, mortality, histopathology, recurrence, and total survival.

Results No significant differences in the demographic or clinical characteristics were observed between the two groups, except that group S had more female patients. Postoperative complications developed in 52% of the patients in group B and 11.1% of the patients in group S (p = 0.006). Mean hospitalization time was 9.6 ± 3.6 (range, 6–19) days in group B and 6.72 ± 1.5 (range, 4–9) days in group S (p = 0.001). All patients received complete resections. The mean patient follow-up time was 42.9 months. No significant difference was found between local and distant recurrences (p = 1, p = 0.432). Mean survival time was 89.6 months (5-year rate = 73%), which was 90.6 months (5-year rate = 75.3%) in group B and 63.1 months (5-year rate = 69.3%) in group S (p = 0.82).

Conclusion This technique allows for reduced filling of the thoracic cavity by a prolonged air leak and a reduced prevalence of complications. Additionally, the hospitalization time is shortened. It does not produce any additional mortality burden, and total survival and oncological outcomes are reliable. This technique can be used in selected patients at experienced centers.