Pulmonary Function After Arterial Sleeve Lobectomy

Study Overview
=================
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.

Official Title
-----------------
Perfusion and Functional Results After Pulmonary Artery Reconstruction During Oncologic Lung Resection

Conditions
-----------------
Lung Cancer, Nonsmall Cell

Intervention / Treatment
-----------------
* Procedure: Lobectomy with pulmonary artery reconstruction


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 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 Exclusion Criteria: 0

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Lobectomy with angioplasty<br>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<br>* 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<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of pulmonary artery reconstruction on pulmonary function | Comparison of post operative predicted FEV1 to post operative FEV1 | 2001-2020 | 
| pulmonary artery reconstruction patency | Patency data of the arterial reconstruction (thoracic angioscan) | 2001-2020 | 
| Pulmonary function according to the type of reconstruction | Comparison of the results (FEV1 ans patency) according to the type of reconstruction | 2001-2020 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
artery pulmonary reconstruction, sleeve lobectomy, lobectomy with angioplasty, arterial sleeve lobectomy, pulmonary function