Comparison of the Results of Parenchymal Sparing Operation and Pneumonectomy for Non-small Cell Lung Cancer

ABSTRACT

PURPOSE: Parenchymal sparing lung surgery indicated for central tumors for which the alternative is pneumonectomy. Pneumonectomy has a higher perioperative mortality risk than lobectomy. To increase resection rates and improve outcomes we have implemented a policy of parenchymal sparing operation for tumors involving a main stem bronchus and pulmonary artery. MATERIALS AND METHODS: From January 2000 to May 2004, 30 pneumonectomies and 30 parenchymal sparing procedures were carried out in the Department of Thoracic and Cardiovascular Surgery of Ajou University Hospital. Suvival and complications were analyzed and compared. Parenchymal sparing operation was always done when technically possible. Thus pneumonectomy was reserved for lesions that could not be removed by a parenchymal sparing operation. RESULTS: There were no significant inter-group differences in perioperative course or outcome and patient characteristics except postoperative stage. One year survival was 56.7% after pneumonectomy and 86.7% after parenchymal sparing operation. The rate of pneumonectomy decreased significantly with increasing experience of parenchymal sparing operation with 21 of the last 32 patients (66%) avoiding pneumonectomy. CONCLUSION: We suggested that as a curative treatment, parenchymal sparing operation may be a safer procedure than pneumonectomy without adversely affecting outcome. Pneumonectomy can be avoided in a large proportion of patients with non-small cell lung cancer