P3-274: Pulmonary artery reconstruction for lung cancer; is this procedure safe and useful?

Bronchoplasty for lung cancer has been widely accepted and became a reliable and safe procedure to preserve lung function. However, pul-monary angioplastic procedure is seldome to be done and there have been only a few reports about pulmonary vascular reconstruction. In order to identify the safety and the usefulness of the pulmonary angioplastic procedure with or without bronchoplasty, we retrospectively reviewed patients medical records in our institution. Between January 1998 and February 2007, 16 cases of pulmonary artery reconstruction were performed. The data were collected from the patient records retrospectively and analyzed. There were three female and 13 male patients, with a mean age of 68 years old (range, 44- 85 years). Four cases received concurrent chemo-radiotherapy prior to surgery and one case received induction chemotherapy. Bronchial anasto-moses were covered with intercostal muscle flap or pericardial fat tissue in these patients with induction therapy. Nine cases were adenocarcinoma, and 7 cases were squamous cell carcinoma. Lung cancer located on left upper lobe in 9 cases, right upper lobe in 3 cases, right middle lobe in 2 cases, and right lower lobe in 2 cases, respectively. Three patients underwent bronchoplasty with pulmo-nary artery reconstruction. Mean operative time was 277±58 minutes and mean blood loss during operation was 497±450g. Post operative complications were seen in 7 cases (44%), including atelectasis in 3 cases, arrhythmia in 3 cases, pneumonia in 2 cases, pneu-mothorax in 1 case, and post operative bleeding combined with cerebral infarction and acute respiratory distress syndrome in 1 case. All patients except one post-operative infarction case were discharged on foot, and their mean hospital stay after operation was 12 days. No operative death was seen and the overall 90-day postoperative mortality rate was zero. Although the mean follow up period was 23 months, the overall survival rate was 67%, so far. Postoperative complication rate after pulmonary artery reconstruction was relatively high, but most of the complications were controllable. Lobectomy assosicated with pulmonary artery reconstruction procedure for lung cancer treatment is useful and feasible, with good intermediate term results.