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

Abstract

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.

Details

Language :
English
ISSN :
1944446X
Volume :
36
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Chinese Journal of Cancer
Publication Type :
Academic Journal
Accession number :
edsdoj.08034e7db62941e6bd6ff26fbacb31c1
Document Type :
article
Full Text :
https://doi.org/10.1186/s40880-017-0220-9