Bronchial sleeve resection or pneumonectomy for XXXX : a propensity-matched analysis of long-term results, survival and quality of life.

@entity1 @entity5 @entity1149 @entity9876 @entity204
BACKGROUND: No randomized studies exist comparing pneumonectomy (PN) and @entity9876 ( @entity9876 ). We evaluated surgical results and long-term quality of life in @entity1 operated on for central @entity1149 ( @entity1149 ) using either @entity9876 or PN. METHODS: A total of 641 @entity1149 @entity1 underwent surgery 2000-2010. @entity9876 was performed in 40 (6.2%) and PN in 67 (10.5%). In 2011, all surviving @entity1 were sent a 15D Quality of Life Questionnaire which 83% replied. Propensity-score-matching analysis was utilized to compare the groups. RESULTS: Thirty-two bronchial (18 right/14 left), seven vasculobronchial (3 right/4 left), one right wedge @entity9876 , and 18 right and 22 left PN were performed. Preoperatively, the Charlson Comorbidity Index (CCI) score, forced expiratory volume in 1 s (FEV1) and diffusion capacity did not differ between groups. The perioperative complication rate and pattern were similar, but @entity9876 group had less major complications (P<0.027). One perioperative @entity204 (2.5%) occurred in @entity9876 group and four (6%) in PN. The 90-day mortality rate was 5% (n=2) for @entity9876 and 7.5% (n=5) for PN. In the follow-up total @entity5 recurrence did not differ (P=0.187). Quality of life measured by 15D showed no significant difference in separate dimensions or total score, except tendency to favor @entity9876 in moving or breathing. The 5-year survival did not differ between groups (P=0.458), but no deaths were observed in @entity9876 group after 5 years. CONCLUSIONS: Due to less major operative complications and better long-term survival, we would advocate using @entity9876 when feasible, but in @entity1 tolerating PN it should be considered if @entity9876 seems not to be oncologically sufficiently radical.
