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Philippe G. Dartevelle
Joseph Khalife
Alain Chapelier
Jean Marzelle
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Ann Thorac Surg 1988;46:68-72
© 1988 The Society of Thoracic Surgeons


Articles

Tracheal Sleeve Pneumonectomy for Bronchogenic Carcinoma: Report of 55 Cases

Philippe G. Dartevelle, M.D.*, Joseph Khalife, M.D., Alain Chapelier, M.D., Jean Marzelle, M.D., Marcelo Navajas, M.D., Philippe Levasseur, M.D., Antonio Rojas, M.D., Jacques Cerrina, M.D.

Department of Thoracic and Vascular Surgery, Marie Lanne-longue Hospital, Plessis Robinson, France

Accepted for publication January 14, 1988.

* Address reprint requests to Dr. Dartevelle, Hôpital Marie Lannelongue, 133 avenue de la Résistance, 92350 Plessis Robinson, France

From 1966 to 1986, a total of 55 patients underwent a tracheal sleeve pneumonectomy (53 right and 2 left) for bronchogenic carcinoma. Preoperative radiotherapy was given in only 5 patients. The overall operative death rate was 10.9%, but no patient has died since 1975 (32 survivors). Seven patients had a postoperative empyema (12.7%); 4 of these patients had a bronchopleural fistula. Twenty-five patients had postoperative radiotherapy, 5 of whom also had chemotherapy. The actuarial survival rate, after exclusion of the 6 operative deaths, was 38% at 3 years and 23% at 5 years. Survival was correlated to regional lymph node involvement. The actuarial survival rate among patients with tumoral spread to bronchial lymph nodes was 43% at 3 years. Among the 13 patients with only subcarinal involvement, the actuarial survival rate was 34% at 3 years. None of the 8 patients with paratracheal lymph node involvement survived more than 30 months.

These results indicate that tracheal sleeve pneumonectomy for bronchogenic carcinoma with extension to the carina is now fully justified considering the low operative mortality and the good results observed when lateral tracheal lymph nodes were not involved.




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