Bronchoplastic and Bronchovascular Procedures of the Tracheobronchial Tree in the Management of Primary Lung Cancer

¹ The Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.

Bronchoplasty has been conducted in a total of 111 lung cancer cases, including 18 cases in stage 1, 19 in stage 2, 62 in stage 3A, 7 in stage 3B and 5 in stage 1, while bronchovascular procedure was indicated in 20 of the 111 cases. The 5-year survival rate of the 111 cases for which bronchoplasty had been performed was 40.5% including 1 operative death; while 5-year survival rate of 20 cases for which bronchovascular procedure was performed was 24.0%; and 78 cases for which curative operation was conducted resulted in the 5-year survival rate of 52.5%. The 5-year survival rates per N factor were 50.0% for NO, 45.9% for N1, 32.5% for N2, and 0% for N3.

Points to be considered for prevention against complication are cautious suture technique including appropriate selection of suture materials, skillful and experienced assistants for the operation, and postoperative good sputum expectoration by bronchofiberscopy.

To preserve pulmonary function, enhance curability, and extend the scope of operative indication, these procedures are particularly applicable for selected cases of squamous cell carcinoma or low-grade malignancy.