Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 16;19(1):234.
doi: 10.1186/s13019-024-02744-5.

A middle lobe sparing sleeve resection versus bilobectomy for right lower central non-small cell lung cancer: a retrospective propensity score matched cohort study

Jiongjie Wang #  1 , Jichao Guo #  2 , Haizhan Shi #  3 , Xiangru Chen  4 , Wenxin He  5 , Zhixin Li  6
Affiliations

A middle lobe sparing sleeve resection versus bilobectomy for right lower central non-small cell lung cancer: a retrospective propensity score matched cohort study

Jiongjie Wang et al. J Cardiothorac Surg. .

Abstract

Objectives: The right lower sleeve lobectomy is a rarely performed major lung resection.This study aims to evaluate the safety and effectiveness of this procedure by comparing to right lower bilobectomy in non-small cell lung cancer patients.

Methods: We retrospectively reviewed a prospective database of non-small cell lung cancer patients who underwent right lower sleeve lobectomy (group S) or right lower bilobectomy (group B) from January 2014 to January 2020 in Shanghai Pulmonary Hospital. Propensity score matching method was applied to balance confounders between the two groups, resulting in 41 matched pairs.The analysis was performed to compare perioperative outcomes, long-term survival, and postoperative pulmonary volume between the two groups.

Results: No significant differences in the characteristics were observed between the two matched groups.Major postoperative complications developed in 31.7% of the patients in group B and 12.1% of the patients in group S (P = 0.032).Intervention rate for surgical residual cavity in group B is significantly higher than those patients in group S(21.9%vs7.3%,p = 0.037).The postoperative right lateral and overall lung volume in group S were both significantly larger than that in group B (P = 0.026,P = 0.001,respectively).

Conclusions: Compared to bi-lobectomy, a middle lobe sparing sleeve resection obtains a less prevalence of major complications, smaller postoperative residual air space and similar long-term survival for selected central right lower NSCLC patients.

Keywords: Bi-lobectomy; Non-small cell lung cancer; Residual space cavity; Right lower lobe; Sleeve resection.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart for inclusion and exclusion of patients
Fig. 2
Fig. 2
(A) The overall survival in the bi-lobectomy group and sleeve resection group before PSM matching; (B) The disease-free survival in the bi-lobectomy group and sleeve resection group before PSM matching. (C) The overall survival in the bi-lobectomy group and sleeve resection group after PSM matching; (D) The disease-free survival in the bi-lobectomy group and sleeve resection group after PSM matching
Fig. 3
Fig. 3
(A) postoperative 3-D construction of bronchus and volume after right lower sleeve resection; (B) postoperative 3-D construction of bronchus and volume after right lower bilobectomy
See this image and copyright information in PMC

References

    1. Deslauriers J, Grégoire J, Jacques LF, et al. Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites or recurrences. Ann Thorac Surg. 2004;77:1152–6. doi: 10.1016/j.athoracsur.2003.07.040. - DOI - PubMed
    1. Maurizi G, Ciccone AM, Rendina EA. The advantage of sleeve lobectomy over pneumonectomy. J Thorac Disease. 2019;11:E103–4. doi: 10.21037/jtd.2019.06.70. - DOI - PMC - PubMed
    1. Predina JD, Kunkala M, Aliperti LA, et al. Sleeve lobectomy: current indications and future directions. Ann Thorac Cardiovasc Surg. 2010;16:310–8. - PubMed
    1. Chen Y, Zhang L, Yan B, et al. Feasibility of sleeve lobectomy after neo-adjuvant chemo-immunotherapy in non-small cell lung cancer. Translational Lung Cancer Res. 2020;9:761–7. doi: 10.21037/tlcr-20-539. - DOI - PMC - PubMed
    1. Boudaya MS, Abid W, Mlika M. Sleeve right lower lobectomy: a rarely performed extended resection. Indian J Surg. 2016;78:74–6. doi: 10.1007/s12262-016-1447-4. - DOI - PMC - PubMed