Anastomosis Complications After Bronchoplasty: Incidence, Risk Factors, and Treatment Options Reported by a Referral Cancer Center

Overview

Journal Curr Oncol

Publisher MDPI

Specialty Oncology

Date 2023 Dec 22

PMID 38132394

Authors

Lara Girelli

Luca Bertolaccini

Monica Casiraghi

Francesco Petrella

Domenico Galetta

Antonio Mazzella

Stefano Donghi

Giorgio Lo Iacono

Andrea Cara

Juliana Guarize

Lorenzo Spaggiari

Affiliations

Soon will be listed here.

Abstract

Background: Sleeve lobectomy with bronchoplasty is a safe surgical technique for the management of lung cancer and endobronchial localization of extrapulmonary cancers. However, anastomotic complications can occur, and treatment strategies are not standardized.

Methods: Data from 280 patients subjected to bronchoplasty were retrospectively analyzed, focusing on surgical techniques, anastomotic complications, and their management. Multivariate analysis was performed, and Kaplan-Meier curves were used to determine survival.

Results: Ninety percent of 280 surgeries were for lung cancer. Anastomotic complications occurred in 6.42% of patients: late stenosis in 3.92% and broncho-pleural fistula in 1.78%. The median survival was 65.90 months (95% CI = 41.76-90.97), with no difference ( = 0.375) for patients with (51.28 months) or without (71.03 months) anastomotic complications. Mortality at 30 days was higher with anastomotic complications (16.7% vs. 3%, = 0.014). Multivariable analysis confirmed pathological stage (N+) as a risk factor for anastomotic complications ( = 0.016). Our mortality (3.93%) and morbidity rate (41.78%) corresponded to recent series results.

Conclusions: In our experience, surgery is preferred to avoid life-threatening complications in bronchopleural fistulas. Bronchoscopic balloon dilatation is preferred for benign strictures. The nodal stage is related to complications ( = 0.0014), reflecting the aggressiveness of surgery, which requires extended radical lymphadenectomy.

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