Pulmonary Function After Arterial Sleeve Lobectomy

NCT04981938 | Completed

• 1 other identifier: CHRUMontpellier
• Study Type: observational
• Target: 81
• Locations: 1 country
• Sites: 1

Brief Summary

Lung cancer is the leading cause of cancer death worldwide. Despite the evolution of medical and multimodal treatments, surgical treatment remains the curative management in the localized cancer. Historically, in central lung tumors, pneumonectomy was the gold standard. Currently, bronchial sleeve lobectomy is recommended as first-line treatment over pneumonectomy when complete resection is possible (Grade 2C). In the case of pulmonary artery invasion, lobectomy with arterial resection and reconstruction is now an accepted option for central localized cancer. Despite surgical challenge, arterial sleeve lobectomy is oncologically comparable with pneumonectomy while avoiding the high morbi-mortality. Indeed, this surgery has shown better results than pneumonectomy in terms of overall survival, post-operative mortality, and quality of life. Initially performed in patients with impaired cardio-pulmonary reserves, this parenchymal sparing procedure can be realised in all patients, when anatomical conditions allow a complete resection. In the literature, no study has yet specifically investigated postoperative respiratory function after arterial sleeve lobectomy. The investigators designed a retrospective monocentric study at the University Hospital of Montpellier on 81 lobectomies with pulmonary artery sleeve resection for lung cancer, from January 2001 to December 2020.

Conditions

Lung Cancer, Nonsmall Cell

Keywords

artery pulmonary reconstruction; sleeve lobectomy; lobectomy with angioplasty; arterial sleeve lobectomy; pulmonary function

Outcome Measures

Primary Outcomes (1)

• Impact of pulmonary artery reconstruction on perfusion on the remaining lung lobe (ventilation/perfusion scan)

  Comparison of perfusion data on pre and post operative ventilation/perfusion scan

  2001-2020

Secondary Outcomes (3)

• Impact of pulmonary artery reconstruction on pulmonary function

  2001-2020

• pulmonary artery reconstruction patency

  2001-2020

• Pulmonary function according to the type of reconstruction

  2001-2020

Study Arms (1)

Lobectomy with angioplasty

81 patients who underwent lobectomy with pulmonary artery reconstruction during oncologic lung resection from January 2001 to December 2020

Procedure: Lobectomy with pulmonary artery reconstruction

Interventions

Lobectomy with pulmonary artery reconstruction PROCEDURE

Lobectomy with pulmonary artery reconstruction under general anesthesia with selective intubation, by postero-lateral thoracotomy in the fifth intercostal space Subgroups : different types of pulmonary artery reconstruction such as : * Tangential vascular reconstruction with direct suture * Circumferential resection and end-to-end anastomosis * bypass reconstruction with heterologous biografts, synthetic grafts, or pericardium patch

Lobectomy with angioplasty

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population includes 81 patients: 18 womens, 63 mens There was no significant difference in patient characteristics. The most common resection was left upper lobectomy (52/81). 61 patients had a lung cancer with invasion of the left pulmonary artery. The most common histology was squamous cell carcinoma (42/81). 28 patients underwent a double sleeve (angioplasty and bronchoplasty) The type of arterial reconstruction was distributed as follows: * 25 bypass * 17 patch angioplasty * 16 circumferential resection and end-to-end anastomosis * 23 tangential vascular reconstruction with direct suture

You may qualify if:

• all major lung resection with pulmonary artery reconstruction for lung cancer
• from January 2001 to December 2020 at University Hospital of Montpellier
• patient \> 18 years

Sponsors & Collaborators

• Centre Hospitalier Régional Universitaire Montpellier: lead

Study Sites (1)

NGUYEN

Montpellier, 34000, France

Location

Related Publications (8)

• D'Andrilli A, Maurizi G, Andreetti C, Ciccone AM, Ibrahim M, Poggi C, Venuta F, Rendina EA. Pulmonary artery reconstruction with pulmonary vein conduit for lung cancer: medium-term results. Ann Thorac Surg. 2014 Sep;98(3):990-5. doi: 10.1016/j.athoracsur.2014.04.110. Epub 2014 Jul 16.

  PMID: 25038016 BACKGROUND

• D'Andrilli A, Maurizi G, Ciccone AM, Andreetti C, Ibrahim M, Menna C, Vanni C, Venuta F, Rendina EA. Long-segment pulmonary artery resection to avoid pneumonectomy: long-term results after prosthetic replacement. Eur J Cardiothorac Surg. 2018 Feb 1;53(2):331-335. doi: 10.1093/ejcts/ezx353.

  PMID: 29029026 BACKGROUND

• Cerezo F, Cano JR, Espinosa D, Salvatierra A. New technique for pulmonary artery reconstruction. Eur J Cardiothorac Surg. 2009 Aug;36(2):422-3. doi: 10.1016/j.ejcts.2009.03.060. Epub 2009 Jun 5.

  PMID: 19501519 BACKGROUND

• Cerfolio RJ, Bryant AS. Surgical techniques and results for partial or circumferential sleeve resection of the pulmonary artery for patients with non-small cell lung cancer. Ann Thorac Surg. 2007 Jun;83(6):1971-6; discussion 1976-7. doi: 10.1016/j.athoracsur.2007.01.048.

  PMID: 17532380 BACKGROUND

• Galetta D, Borri A, Gasparri R, Petrella F, Spaggiari L. Surgical Techniques and Long-Term Results of Pulmonary Artery Reconstruction in Patients With Lung Cancer. Ann Thorac Surg. 2015 Oct;100(4):1196-202; discussion 1202. doi: 10.1016/j.athoracsur.2015.04.124. Epub 2015 Jul 21.

  PMID: 26209482 BACKGROUND

• Gomez-Caro A, Martinez E, Rodriguez A, Sanchez D, Martorell J, Gimferrer JM, Haverich A, Harringer W, Pomar JL, Macchiarini P. Cryopreserved arterial allograft reconstruction after excision of thoracic malignancies. Ann Thorac Surg. 2008 Dec;86(6):1753-61; discussion 1761. doi: 10.1016/j.athoracsur.2008.06.027.

  PMID: 19021970 BACKGROUND

• Ma Q, Liu D, Guo Y, Shi B, Tian Y, Song Z, Zhang Z, Ge B, Wang X, D'Amico TA. Surgical techniques and results of the pulmonary artery reconstruction for patients with central non-small cell lung cancer. J Cardiothorac Surg. 2013 Dec 1;8:219. doi: 10.1186/1749-8090-8-219.

  PMID: 24289720 BACKGROUND

• Madariaga MLL, Geller A, Lanuti M, Ott H, Allan JS, Donahue DM, Mathisen DJ, Wright CD, Gaissert HA. Pulmonary Artery Resection During Lung Resection for Malignancy. Ann Thorac Surg. 2019 Dec;108(6):1692-1700. doi: 10.1016/j.athoracsur.2019.05.079. Epub 2019 Jul 20.

  PMID: 31336066 BACKGROUND

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MeSH Terms

Conditions

Carcinoma, Non-Small-Cell Lung

Condition Hierarchy (Ancestors)

Carcinoma, Bronchogenic; Bronchial Neoplasms; Lung Neoplasms; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Study Officials

• SOLOVEI Laurence

  University Hospital, Montpellier

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Thoracic surgery resident

Study Record Dates

• First Submitted: July 23, 2021
• First Posted: July 29, 2021
• Study Start: July 22, 2021
• Primary Completion: July 31, 2021
• Study Completion: September 1, 2021
• Last Updated: September 17, 2021

Record last verified: 2021-07

Locations

FR (1)