Surgical results of 40 patients with malignant tracheobronchial lesions

The objective of this study was to evaluate the results of tracheobronchoplasty performed on a variety of malignant diseases which involved the tracheobronchus. Between July 1988 and March 1996 tracheobronchial surgery was performed on 40 patients who had a variety of malignant diseases. The primary diseases were bronchogenic carcinoma (n = 26), tracheobronchial tumour (n = 5), thyroid cancer (n = 6), and oesophageal cancer (n = 3). Operative procedures that were performed on the tracheobronchus were sleeve lobectomy (n = 22) or bilobectomies (n = 5), sleeve pneumonectomy (n = 3), sleeve resection of trachea (n = 7) and bronchus (n = 3). There was one postoperative death with a mortality rate of 2.5%. However, there were no significant postoperative complications apart from the one postoperative death; one patient developed a bronchopleural fistula and empyema. In lung cancer patients, the 2 year survival rate was 47.3%, and one (3.8%) local tumour recurrence. Four of five patients who had tracheobronchial turnouts were alive and free from disease during 2-6 year follow-up period. One patient who had malignant fibrous histiocytoma died of brain metastasis 6 months after the operation. Among six patients whose thyroid cancer involved the trachea, one patient survived for 7 years, the other five patients were still alive and free from disease 2-5 years after the operation. Of the three patients whose oesophageal carcinoma involved the tracheobronchus, there was one operative death and the others died of tumour recurrence 1 and 2 years, respectively. We suggest that tracheobronchoplasty is a safe procedure with low morbidity and mortality rates in carefully selected patients with malignant diseases.