Department of Thoracic Surgery, Malteser Hospital Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Germany.
Lung Clinic, Cologne-Merheim Hospital, Witten/Herdecke University, Cologne, Germany.
J Surg Oncol. 2021 Feb;123(2):553-559. doi: 10.1002/jso.26286. Epub 2020 Nov 6.
It is unclear how much additional perioperative risk a sleeve lobectomy could pose in comparison to lobectomy. The objective of this analysis was to compare the complication rate, 30-day mortality, and overall survival between lobectomy and sleeve lobectomy without prior neoadjuvant treatment in non-small-cell lung cancer (NSCLC).
This is a retrospective study using our prospective database for quality assurance in our hospital. Inclusion criteria for our study was a completed lobectomy or sleeve lobectomy for primary treatment of NSCLC.
In 506 patients, the tumor was treated by means of standard lobectomy. In 252 patients with central tumor localization, sleeve lobectomy was performed. Postoperative complications occurred in n:148 (29.24%) patients of the lobectomy group and in n = 76 (30.15%) of the sleeve group. The mortality rate difference between the two groups was statistically significant and favored the lobectomy group (0.78% vs. 4.76%, p = .007). Five year survival was 69.97% for the lobectomy and 65.59% for the sleeve group (p = .829).
Sleeve lobectomy for primary surgical treatment of NSCLC has comparable perioperative complications with lobectomy. Sleeve lobectomy does not seem to negatively influence survival. Postoperative mortality was higher in the sleeve group.
袖状肺叶切除术与肺叶切除术相比，会增加多少围手术期风险尚不清楚。本分析的目的是比较非小细胞肺癌（NSCLC）患者中未经新辅助治疗的肺叶切除术与袖状肺叶切除术的并发症发生率、30 天死亡率和总生存率。
这是一项使用我们医院质量保证的前瞻性数据库进行的回顾性研究。本研究的纳入标准为完成肺叶切除术或袖状肺叶切除术作为 NSCLC 的初始治疗。
在 506 例患者中，肿瘤采用标准肺叶切除术治疗。在 252 例肿瘤位于中央的患者中，行袖状肺叶切除术。肺叶切除术组 n=148（29.24%）例患者和袖状组 n=76（30.15%）例患者发生术后并发症。两组死亡率差异具有统计学意义，肺叶切除术组更有利（0.78%比 4.76%，p=0.007）。肺叶切除术组和袖状组的 5 年生存率分别为 69.97%和 65.59%（p=0.829）。
袖状肺叶切除术作为 NSCLC 主要的手术治疗方法，其围手术期并发症与肺叶切除术相当。袖状肺叶切除术似乎不会对生存率产生负面影响。袖状组的术后死亡率更高。
