Sleeve lobectomy: to wrap or not to wrap the bronchial anastomosis?

Abstract

Abstract Background Bronchoplastic procedures have become the gold standard in the lung parenchyma sparing treatment of centrally located bronchopulmonary tumors. Two schools of thought exist when performing a bronchial sleeve resection, those who wrap the anastomosis with a pedicled flap and those who leave the anastomosis unprotected. To the best of our knowledge no studies have been performed comparing these two methods. Methods This study is a retrospective multi-center observational analysis of 90 consecutive patients undergoing bronchial sleeve resections for neoplastic disease between June 2009 and July 2019. Group A (60 patients) underwent bronchial wrapping and group B (30 patients) did not undergo wrapping. Results The only difference between group A, 5 (8.3%) patients, and group B, 10 (33.3%) patients, for general characteristics was the presence of diabetes (p=0.003). There were no differences in surgical, post-operative and follow-up characteristics. There was no statistically significant difference between the two groups [group A 9 (15%) and group B 6 (20%) patients] in terms of anastomotic complications at 1-year (p=0.425). Diabetes was found to be an independent predictive factor for anastomotic complications at 1-year (p=0.035). Number of postoperative complications (p Conclusions We found no differences between the two groups in terms of postoperative complications and length of hospital stay, confirming previous reports that sleeve resections may be performed safely without bronchial wrapping.