| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||
Ann Thorac Surg 2000;70:371-372
© 2000 The Society of Thoracic Surgeons
 |
Discussion |
|---|
 Top Discussion |
|---|
Dr. Lausberg: When you review the literature, it is always a matter of discussion that sleeve resection or the indication of sleeve resection is limited due to the fear of bronchial anastomotic complications. Since the introduction of lung transplantation and the positive experience during the recent years having shown that bronchial anastomosis can be performed without an increase in mortality and morbidity, we came to approach the sleeve resection more often.
Dr. Ludwig Lampl (Augsberg, Germany): I enjoyed your paper, Dr Lausberg. For me, a little bit surprising are your relations. Twenty-five of all lobectomies are sleeve lobectomies, or, in other terms, there are twice as many sleeves as pneumonectomies. Another thing is 3.6 ± 11.2 days of artificial ventilation after pneumonectomy. And the third surprising data, the gap between zero stump problems in sleeve resection (congratulations for that) and 7.5% for pneumonectomy seems remarkable to me. Could you please explain that surprising data a little bit?
Dr. Lausberg: I would like to refer to your first comment first. In our region, we have become a referral center for patients with central bronchial tumors. It is true that we aggressively approach sleeve resection and try to apply it whenever possible.
The other comment you made refers to the gap between 7.5% in the complication rate, bronchial complication rate in the pneumonectomy group, and the 0% in the sleeve resections. We do not have a good explanation beyond the descriptions of our results.
Dr. Paul E. Van Schil (Antwerp, Belgium): Could you please comment on the long-term survival in relation to postoperative staging and nodal involvement? In the series we presented 4 years ago (Ann Thorac Surg 1996;61:1087–91), nodal involvement was found to be the most significant factor in relation to long-term survival in a multivariate analysis.
Dr. Lausberg: Could you repeat your question, please?
Dr. Van Schil: Could you give the results in relation to postoperative staging of the patients, the pTNM classification, and the nodal involvement, N0 versus N1 and N2 disease?
Dr. Lausberg: Basically we made the same experience that has been formerly reported in the literature. Nodal involvement has been the major factor that influences postoperative survival. The patients with N2 disease really had a worse survival than other patients. We did not find any influence of the T tumor stage between 2 and 3.
Dr. Van Schil: Do you think some N1 nodes or N2 nodes are a contraindication to a sleeve lobectomy or sleeve resection?
Dr. Lausberg: We do not think that way, because whenever we have N2 involvement, the patient will either undergo neoadjuvant treatment or postoperative radiation.
Related Article
Ann. Thorac. Surg. 2000 70: 367-371.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
