Clinical trial NCT04981938: Pulmonary Function After Arterial Sleeve Lobectomy
Official title: Perfusion and Functional Results After Pulmonary Artery Reconstruction During Oncologic Lung Resection
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Lung Cancer, Nonsmall Cell
Keywords: artery pulmonary reconstruction
sleeve lobectomy
lobectomy with angioplasty
arterial sleeve lobectomy
pulmonary function
Lead sponsor: Centre Hospitalier Régional Universitaire Montpellier
Sponsor class: OTHER
First posted: 2021-07-29
Enrollment: 81
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
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

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.


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

Primary outcomes:
measure: Impact of pulmonary artery reconstruction on perfusion on the remaining lung lobe (ventilation/perfusion scan)
timeFrame: 2001-2020
Secondary outcomes:
measure: Impact of pulmonary artery reconstruction on pulmonary function
timeFrame: 2001-2020
measure: pulmonary artery reconstruction patency
timeFrame: 2001-2020
measure: Pulmonary function according to the type of reconstruction
timeFrame: 2001-2020
Other outcomes:
Locations:
city: Montpellier
country: France
facility: NGUYEN
Study officials:
affiliation: University Hospital, Montpellier
name: SOLOVEI Laurence
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.
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citation: 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.
citation: 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.
citation: 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.