1Republican Clinical Hospital, Kazan
2Kazan (Volga Region) Federal University, Institute of Fundamental Medicine and Biology, Kazan
Kirshin Aleksandr A. ― Head of Surgical Department №2 of the Republican Clinical Hospital, Assistant of the Department of Surgical Diseases of Postgraduate Education of Kazan (Volga Region) Federal University, Institute of Fundamental Medicine and Biology
138A Orenburgskiy trakt, Kazan, 420064, Russian Federation, tel. +7-912-467-52-79, e-mail: firstname.lastname@example.org, SPIN-code: 3854-0649, Author ID: 1044593, ORCID ID: 0000-0002-3322-4284, SCOPUS ID: 57215966198, Web of Science Researcher ID: AAI-6509-2021
Aim ― to develop a strategy and methodology for resection and reconstruction of the pulmonary artery during operations for lung cancer.
Material and methods. In the volume of angioplastic lobectomy (APL), 92 patients were operated with a diagnosis of non-small cell lung cancer, 69 of them were men (75%) and 23 women (25%), the average age was 57,8±6,7 years.
Results. For right lung cancer, 27 angioplastic lobectomies were performed in 9 different variants of pulmonary artery resection and reconstruction, for left lung cancer ― 65 operations in 6 variants. 47 marginal resections of the pulmonary artery were performed with suturing of the defect along or across the axis of the vessel, 11 resections of the pulmonary artery with patch (autopericardium, pulmonary vein of the removed lobe), 29 circular resections of the pulmonary artery with the formation of a direct anastomosis and 5 circular resections of the pulmonary artery using grafts. Postoperative complications occurred in 23 cases (25%), 3 (3,3%) deaths were registered. The observed one-year survival of patients with stage I-III lung cancer after angioplastic lobectomy was 96,7%, 3-year ― 65,1%, 5-year ― 36,6%, median survival was 53,1 months; relapse-free survival was 89,9%, 65,3%, 48,8%, respectively, with a median of 49,8 months.
Conclusion. The developed strategy and methodology of angioplastic lobectomies allowed to obtain acceptable immediate and long-term results. No local tumor recurrence associated with the pulmonary artery reconstruction zone was registered. Lobectomy with vascular reconstructive component is technically feasible and safe procedure.
Key words: lung cancer, pulmonary artery resection, angioplastic lobectomy, organ-sparing surgery.