Author of

• 16935

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  P1.08 - Poster Session with Presenters Present (ID 460)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16997

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    P1.08-062 - The Short and Long-Term Outcomes of Completion Pneumonectomy Compared with Primary Pneumonectomy (ID 5828)

    14:30 - 14:30  |  Author(s): T. Ueda
    • Abstract

    Background:
    Completion pneumonectomy has been reported to be high morbidity and mortality procedure in lung cancer patients. However, we sometimes have no choice but to apply this procedure for the patients who developed secondary lung cancer in the remaining lung after lung resection, local recurrence, or postoperative complication. In this study, we investigated the short and long-term outcomes of completion pneumonectomy compared with primary pneumonectomy in our single institution.
    
    Methods:
    Between January 1997 and December 2014, 243 patients who underwent pneumonectomy in our institution were enrolled in this study. Retrospectively, we investigated the postoperative complication, short and long-term outcomes of the patients who underwent completion pneumonectomy (CP) and primary pneumonectomy (PP). CP was defined as pneumonectomy in patients with previous lung resection conducting a hilar manipulation.
    
    Results:
    Thirty-three patients (14%) of 243 patients underwent CP. CP was performed for 28 malignant tumors and 5 benign diseases. Postoperative severe complication (CTCAE Grade3 or more) occurred in 36% of CP group and 12% of PP group (p<0.01).Especially, bronchopleural fistula (BPF) was more likely to occur in patients undergoing CP (PP 5％ vs CP 15%, p=0.03). The incidence of BPF in PP group was related to the side of procedure (right 70% versus left 30%, p=0.01), but those in CP group was not related (right 60% versus left 40%, p=0.57). In the patient with BPF after CP, Bronchial stump coverage was performed in 2 of 5 patients undergoing the right-side procedure, not performed in other 3 of 5 patients (2 left-side and 1 right-side). The 30-day mortality for CP group (9%) was a significantly higher compared with PP group (2％, p=0.04). However, the 90-day mortality (PP 5％ vs CP 12％, p=0.14) and the overall survival (PP 47％ vs CP 52％, p=0.44 ) were not significant difference between the two groups.
    
    Conclusion:
    Postoperative morbidity and 30-days mortality rates in CP were higher than those in PP group, but the long-term survival of CP is acceptable compared with PP group. The incidence of left-side BPF is similar to right-side in CP group in this study. It will be also necessary to take preventive procedure against BPF (bronchial stump coverage) in left-side CP.