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Ann Thorac Surg 1994;57:1529-1532
© 1994 The Society of Thoracic Surgeons

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Articles

Management of anastomotic complications after sleeve lobectomy for lung cancer

First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan

Accepted for publication September 20, 1993.

^_* Address reprint requests to Dr Kawahara, First Department of Surgery, Nagasaki University School of Medicine, Sakamoto Athome 7-1, #852, Nagasaki, Japan.

One hundred twelve patients (102 male and 10 female) underwent sleeve lobectomy for lung oncer from January 1969 to December 1991. Bronchopleural fistula occurred in 6 (5.6%), bronchovascular fistula in 2 (1.6%), pulmonary aiterial occlusion in 2 (1.9%), anastomotic stricture or stenosis in 7 (6.3%), and local recurrence in 7 patients (6.3%). Early repair of bronchopleural fistula combined with an omentopexy achieved permanent closure of the fistula. Two patients who underwent a completion pneumonectomy for a pnlmonary arterial occlusion died of respiratory failure. Two patients experienced uncontrollable bleeding into the bronchial tree through a bronchovascular fistula and sudden death. Completion pneumonectomy is indicated for a stricture due to scar formation. If pneumonectomy is precluded by poor pulmonary reserve, endoscopic excision using biopsy forceps is an alternative. Endcscopic resection is the treatent of choice for suture granulomas. Complications associated with bronchial or vascular anastomoses are serious and frequently fatal.

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