Left Versus Right Bronchial Sleeve Resections; Characteristics And Outcomes From The Seer Database
Mirza Zain Baig1, Joanna Weber1, Cliff Connery2, Faiz Bhora3
1Nuvance Health, Danbury, CT, USA, 2Nuvance Health, Poughkeepsie, NY, USA, 3Nuvance Health, Poughkeepsie, CT, USA
Background: Bronchial sleeve resection is an uncommon surgical procedure that involves resection of the main bronchus with lung parenchymal preservation. The normal anatomy of the airway and the pulmonary hilum hinder the approach on the left side making it a more technically demanding procedure. In this study, we compare left versus right-sided bronchial sleeve resections using a large population-based dataset.
Methods: The Surveillance, Epidemiology and End Results (SEER) database was queried for patients with lung cancers treated with primary bronchial sleeve resections between 2004 to 2015. Patients with multiple primary cancers were excluded from our final cohort. Demographic information, tumor characteristics, treatment and survival outcomes were investigated.
Results: A total of 200 patients met our inclusion criteria. The majority of the patients were white (90%) and female (52.5%) with a mean age of 52.36 (±17.08). Right-sided bronchial sleeve resections were done in 107 (53.5) patients whereas left-sided bronchial sleeve resections were done in 93 (46.5%) patients. There were no significant differences in gender distribution, race and decade (2004-2009 vs 2010-2015) between the two groups. Patients who underwent right-sided bronchial sleeve resections were found to be older (54.9 vs 49.5 years, p = 0.04) and had tumors located in the upper lobe (47.7%), main bronchus (20.6%), middle lobe (11.2%) and lower lobe (10.3%). Patients who underwent left-sided bronchial sleeve had tumors located in the main bronchus (39.8%), upper lobe (38.7%) and lower lobe (16.1%). Carcinoid was the most common tumor in both groups (29.9% and 45.2%) followed by squamous cell carcinomas (18.7% and 17.2%). Left-sided bronchial sleeves demonstrated a longer mean survival than right-sided sleeves, though this was not statistically significant (106.83 versus 89.9 months, p = 0.07).
Conclusion: We present the largest dataset comparing left and right bronchial sleeve resections. The two groups appear to be similar in patient and tumor characteristics as well as survival outcomes.
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