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Eur J Cardiothorac Surg 2007;31:717-718. doi:10.1016/j.ejcts.2007.01.030
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Editorial comment

^a Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
^b Department of Epidemiology, UAB School of Public Health, Birmingham, AL, United States

^_* Address: Division of Cardiothoracic Surgery, University of Alabama at Birmingham, 1900 University Blvd., THT 712, Birmingham, AL 35294, United States. Tel.: +1 205 934 5937; fax: +1 205 934 6218. (Email: rcerfolio@uab.edu).

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Dr Venuta and colleagues have provided a well written and important report on their fourteen year experience of pulmonary resection in patients with non-small cell lung cancer who have received neo-adjuvant chemo or chemo-radiotherapy [1]. The main import from this retrospective study is that lobectomy can be performed safely after neoadjuvant chemo-radiotherapy in experienced hands. Several previous articles have also supported this finding. The importance of muscle flaps or pedicled flaps to protect the bronchus, although not mentioned in this article cannot be underestimated. Thus, the only controversy presented is the risk of pneumonectomy after induction chemotherapy or concomitant chemo-radiotherapy.

The most striking finding from Dr Venuta's study is that four of the five operative deaths occurred in patients who underwent pneumonectomy. First, this means that only one of the 106 patients who underwent lobectomy experienced an operative mortality. This fantastic result lauds the outstanding technical expertise of Dr Venuta and his surgical colleagues, since lobectomy after . . . [Full Text of this Article]