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Mithi MT, Sharma M, Puj K, Devarajan JA, Joshi N, Pandya SJ, Patel S, Warikoo V, Rathod P, Pandya S, Salunke A, Patel K, Garg V. Surgery for lung cancer: insight from a state cancer centre in India. Indian J Thorac Cardiovasc Surg 2024; 40:50-57. [PMID: 38125328 PMCID: PMC10728424 DOI: 10.1007/s12055-023-01590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose Lung cancer is one of the most common cancers in India. However, less than half receive treatment with a curative intent and very few undergo surgery amongst them. We present our surgical experience with non-small cell lung cancer. Methods A retrospective analysis of a cohort of 92 non-small cell lung cancer patients operated with curative intent. Results Less than 2% patients of lung cancer were operated on at our centre. Adenocarcinoma was the most common histological subtype. Right upper lobectomy was the most common surgery performed. Two- and 3-year overall survival was 74.3% and 70.6% respectively. Two- and 3- year disease-free survival was 65.4% and 60.8% respectively. Conclusion The fraction of patients who are operated for lung cancer is very less. There is a definite missed window of opportunity. We have comparable survival to international data.
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Affiliation(s)
- Mohamed Taher Mithi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohit Sharma
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Ketul Puj
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Jebin Aaron Devarajan
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Nilang Joshi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shashank J. Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shailesh Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vikas Warikoo
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Priyank Rathod
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shivam Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Abhijeet Salunke
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Keval Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vasudha Garg
- Department of Medicine, BJ Medical College, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
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Skrzypczak PJ, Kasprzyk M, Piwkowski C. The review of the management and prevention methods of bronchopleural fistula in thoracic surgery. J Thorac Dis 2023; 15:5268-5271. [PMID: 37969259 PMCID: PMC10636441 DOI: 10.21037/jtd-23-1231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 11/17/2023]
Affiliation(s)
| | - Mariusz Kasprzyk
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego, Poznań, Poland
| | - Cezary Piwkowski
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Szamarzewskiego, Poznań, Poland
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Porkhanov VA, Zhikharev VA, Bushuev AS, Zima VS, Koryachkin VA, Ivanova MP. [Early predictor of bronchial suture failure after pneumonectomy]. Khirurgiia (Mosk) 2023:71-77. [PMID: 37916560 DOI: 10.17116/hirurgia202310171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To identify the relationship between serum CRP/albumin and bronchial suture failure after pneumonectomy. MATERIAL AND METHODS A retrospective analysis included 100 patients who underwent pneumonectomy with extended lymph node dissection for lung cancer. Patients were divided into 2 groups depending on postoperative complications: group 1 - bronchial stump failure, group 2 - no similar complications. In all patients, we analyzed markers of inflammation (C-reactive protein and albumin) in preoperative period and after 24 postoperative hours. Bronchial stump failure was found in 20 patients (10 patients (14.7%) after left-sided pneumonectomy and 10 (31%) patients after right-sided pneumonectomy). We found a significant relationship between serum CRP/albumin and bronchial stump failure after pneumonectomy (p<0.05). A prognostic formula was based on the ratio of serum C-reactive protein and albumin: PC = CRP/Alb, where PC - prognostic coefficient, CRP - serum C-reactive protein (mg/l) 24 hours after surgery, Alb - serum albumin (g/l) 24 hours after surgery. PC >2.6 determines high risk of bronchial stump failure after pneumonectomy, PC <2.6 - low risk. Sensitivity of this method is 90%, specificity - 97.5%.
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Affiliation(s)
- V A Porkhanov
- Research Institution - Ochapovsky Regional Clinic Hospital No. 1, Krasnodar, Russia
- Kuban State Medical University, Krasnodar, Russia
| | - V A Zhikharev
- Research Institution - Ochapovsky Regional Clinic Hospital No. 1, Krasnodar, Russia
- Kuban State Medical University, Krasnodar, Russia
| | - A S Bushuev
- Research Institution - Ochapovsky Regional Clinic Hospital No. 1, Krasnodar, Russia
| | - V S Zima
- Research Institution - Ochapovsky Regional Clinic Hospital No. 1, Krasnodar, Russia
| | - V A Koryachkin
- St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M P Ivanova
- Astana Medical University, Astana, Republic of Kazakhstan
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Gallyamov EA, Nikulin AV, Diduev GI, Malofei AM, Romanikhin AI, Surkov AI, Gvozdev AA, Fetlam DL. THE USE OF FIBRIN GLUE IN THE TREATMENT OF BRONCHIAL STUMP FAILURE AFTER LOWER LOBECTOMY ON THE RIGHT (A CLINICAL CASE). SURGICAL PRACTICE 2022. [DOI: 10.38181/2223-2427-2022-3-49-55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Despite the constantly improving technique of operations, the use of modern suture materials and stitching-cutting devices, the problem of the occurrence of the failure of the bronchial stump remains unresolved. Many methods have been proposed for the treatment of bronchial stump failure, ranging from endoscopic mucosal coagulation and the installation of various types of occluders and ending with repeated surgical interventions. There are a huge number of publications devoted to the use of fibrin glue in various fields of medicine, for example, in neurosurgery, maxillofacial surgery, orthopedics, dentistry and thoracic surgery, fibrin glue is successfully used, including in the development of bronchial stump failure. This article presents a clinical observation of the use of fibrin glue in the treatment of bronchial stump failure after lower lobectomy on the right.
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Affiliation(s)
- E. A. Gallyamov
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - A. V. Nikulin
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - G. I. Diduev
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - A. M. Malofei
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - A. I. Romanikhin
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - A. I. Surkov
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - A. A. Gvozdev
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
| | - D. L. Fetlam
- City Clinical Hospital No. 23 named after I. V. Davydovsky of the Department of Health of the City of Moscow
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Skrzypczak P, Roszak M, Kasprzyk M, Dyszkiewicz W, Kamiński M, Gabryel P, Piwkowski C. The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer-a cross-sectional study. J Thorac Dis 2022; 14:3343-3351. [PMID: 36245618 PMCID: PMC9562551 DOI: 10.21037/jtd-22-240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022]
Abstract
Background Pneumonectomy is a high-risk radical resection procedure, with bronchopleural fistula (BPF) being its most challenging and severe complication. This study aimed to assess the surgical risk factors and the impact of the bronchial stump closure technique on the incidence of the BPF. Methods This is a single-center, cross-sectional study of the medical records of 455 post-pneumonectomy patients operated due to non-small cell lung cancer (NSCLC) in 2006-2017. We analyzed the following variables and their influence on the occurrence of the BPF: operation side, surgical techniques (i.e., manual suture or the stapler), stump buttressing, the extension of pneumonectomy, comorbidities, and postoperative complications. Results BPF occurred in 7.47% of post-pneumonectomy patients. BPF was more prevalent in right-sided pneumonectomy versus left-sided (10.98% vs. 5.32%; P=0.026). The use of a stapler or manual suture was not associated with the incidence of the BPF (7.96% vs.7.09%, P=0.72). There were no significant differences in the occurrence of BPF among bronchial stump buttressing with the parietal pleura (P=0.80), intercostal muscle flap (IMF) (P=0.46), and pericardial fat pad (P=0.88). When comparing data from 2006-2012 with those from 2013-2017, we found a steady decrease in the number of performed stump reinforcements, but this was not associated with a higher risk of BPF. Conclusions The method used for stump closure, additional tissue buttressing of the bronchial stump and year of the surgery had no significant impact on the occurrence of BPF. Only right-sided pneumonectomy was associated with higher BPF occurrence.
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Affiliation(s)
- Piotr Skrzypczak
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Mariusz Kasprzyk
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Wojciech Dyszkiewicz
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Mikołaj Kamiński
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Piotr Gabryel
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Cezary Piwkowski
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
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