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Thorac Cardiovasc Surg 2025; 73(02): 165-173
DOI: 10.1055/a-2382-8087
Original Thoracic

Evaluation of Risk Factors for Early Insufficiency after Bronchial Sleeve Resections

Evgeny Levchenko
1   Department of Thoracic Oncology, N. N. Petrov National Medical Research Center of Oncology, Sankt-Peterburg, Russian Federation
,
Viktoriia Shabinskaya 
1   Department of Thoracic Oncology, N. N. Petrov National Medical Research Center of Oncology, Sankt-Peterburg, Russian Federation
,
Nikita Levchenko
1   Department of Thoracic Oncology, N. N. Petrov National Medical Research Center of Oncology, Sankt-Peterburg, Russian Federation
,
Alexander Mikhnin
1   Department of Thoracic Oncology, N. N. Petrov National Medical Research Center of Oncology, Sankt-Peterburg, Russian Federation
,
Oleg Mamontov
1   Department of Thoracic Oncology, N. N. Petrov National Medical Research Center of Oncology, Sankt-Peterburg, Russian Federation
,
Stepan Ergnyan
1   Department of Thoracic Oncology, N. N. Petrov National Medical Research Center of Oncology, Sankt-Peterburg, Russian Federation
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Abstract

Background Bronchoplastic resections are now widely used as a surgical treatment for resectable central lung cancer. However, bronchial dehiscence is one of the most life-threatening complications, making it important to identify its risk factors to separate patients who require more attention during the postoperative period.

Methods The data of 285 patients who underwent bronchoplasty from 2006 to 2021 were retrospectively reviewed. We collected demographic characteristics, history of neoadjuvant therapy, preoperative assessment, perioperative outcomes, and postoperative complications to investigate different variables as risk factors for bronchial dehiscence by univariate and multivariate analyses.

Results Bronchial dehiscence was diagnosed in 12 patients (4.2%) with a mean presentation on postoperative day 10 (range: 1–24 days). By multivariate analysis, current smoking (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.1–20.1, p = 0.032), chronic obstructive pulmonary disease (COPD; OR: 6.5, 95% CI: 1.2–33.8, p = 0.027), bronchoplastic right lower lobectomy (OR: 12.9, 95% CI: 2.4–69.7, p = 0.003), and upper sleeve bilobectomy with segmentectomy S6 by performing an anastomosis between right main bronchus (RMB) and bronchus of basal pyramid (BP) (OR: 30.4, 95% CI: 3.4–268.1, p = 0.002) were confirmed as relevant risk factors for developing bronchial dehiscence.

Conclusion Current smoking, COPD, bronchoplastic right lower lobe, and upper l with segmentectomy S6 by performing an anastomosis between RMB and bronchus of BP were identified with the occurrence of bronchial dehiscence after sleeve resection.

Keywords

lung cancer treatment (surgery medical) - surgery - complications


Publication History

Received: 13 February 2024

Accepted: 06 August 2024

Accepted Manuscript online:
08 August 2024

Article published online:
29 August 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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