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Ann Thorac Surg 1993;55:1501-1507
© 1993 The Society of Thoracic Surgeons

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Articles

Bronchoplastic and angioplastic techniques in the treatment of bronchogenic carcinoma

Department of Thoracic Surgery, University of Torino, Torino, Italy

Received for publication September 26, 1992. ^_* Address reprint requests to Dr Maggi, Department of Thoracic Surgery University of Torino, 3, Via Genova 10126 Torino, Italy.

From 1979 to 1991, 51 bronchoplasties, 18 angioplasties, and 4 combined broncho-angioplaslies were performed for bronchogenic carcinoma. Sixteen patients underwent operation because of compromised pulmonary function; bronchoplasty, angioplasty, or the combined procedure was performed in the remaining 57 patients because of a suitable anatomic location of the neoplasm. Twenty-four patients had stage I disease, 32 stage II, and 17 stage IIIa. Three patients died postoperatively (3.65%). Major post-operative complications occurred in 20 patients (27.3%) (10 early, and 10 late). A completion pneumonectomy was required in 4 patients (5.4%), 2 for anastomotic stricture, 1 because of vascular thrombosis after angioplasty, and 1 for local recurrence after angioplasty. Three-year and 5-year survival rates for the entire group were 55.4% and 40.8%, respectively. One-year and 3-year survival rates after angioplasty were 78.6% and 31.4%. Of the 4 patients who underwent a combined broncho-angioplastic procedure, 1 died after 23 months and 3 are alive and well after 11, 15, and 20 months. Survival was more favorable in the combined N0-N1 group (62% and 43.1%) than in the N2 group (23.4%), but the difference was not significant (p < 0.2). Three-year survival after angioplasty was found to be lower than, although not significantly different from, the overall 3-year survival rate (31.4% versus 55.4%; p = not significant). No statistically significant differences were found among survival rates of patients with compromised and noncompromised pulmonary reserve. We conclude that bronchoplastic and angioplastic procedures are valid techniques as curative operations in carefully selected patients with bronchogenic carcinoma. The value of the combined broncho-angioplastic operations needs further evaluation, although results thus far are encouraging.

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