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Different dissecting orders of the pulmonary bronchus and vessels during right upper lobectomy are associated with surgical feasibility and postoperative recovery for lung cancer patients

Authors :
Ben-Yuan Jiang
Hai-Yan Tu
Hao-Ran Zhai
Yi-Long Wu
Xue-Ning Yang
Xu-Chao Zhang
Jin-Ji Yang
Qing Zhou
Wei Li
Song Dong
Ri-Qiang Liao
Qiang Nie
Wen-Zhao Zhong
Source :
Chinese Journal of Cancer, Chinese Journal of Cancer, Vol 36, Iss 1, Pp 1-10 (2017)
Publication Year :
2016

Abstract

Background Right upper lobectomy (RUL) for lung cancer with different dissecting orders involves the most variable anatomical structures, but no studies have analyzed its effects on postoperative recovery. This study compared the conventional surgical approach, VAB (dissecting pulmonary vessels first, followed by the bronchus), and the alternative surgical approach, aBVA (dissecting the posterior ascending arterial branch first, followed by the bronchus and vessels) on improving surgical feasibility and postoperative recovery for lung cancer patients. Methods According to the surgical approach, consecutive lung cancer patients undergoing RUL were grouped into aBVA and VAB cohorts. Their clinical, pathologic, and perioperative characteristics were collected to compare perioperative outcomes. Results Three hundred one patients were selected (109 in the aBVA cohort and 192 in the VAB cohort). The mean operation time was shorter in the aBVA cohort than in the VAB cohort (164 vs. 221 min, P 0.05). The median disease-free survival was comparable for all patients in the two cohorts (not arrived vs. 41.97 months) and for patients with disease recurrences (13.25 vs. 9.44 months) (both P > 0.05). The recurrence models in two cohorts were also comparable for patients with local recurrences (6.4% vs. 7.8%), distant metastases (10.1% vs. 8.3%), and both (1.8% vs. 1.6%) (all P > 0.05). Conclusions Dissecting the right upper bronchus before turning over the lobe repeatedly and dissecting veins via the aBVA approach during RUL would promote surgical feasibility and achieve comparable postoperative recovery for lung cancer patients. Electronic supplementary material The online version of this article (doi:10.1186/s40880-017-0220-9) contains supplementary material, which is available to authorized users.

Details

ISSN :
1944446X
Volume :
36
Issue :
1
Database :
OpenAIRE
Journal :
Chinese journal of cancer
Accession number :
edsair.doi.dedup.....e46920702729bdf187ec16940cc8bc9a