Eur J Cardiothorac Surg 2007;31:141. doi:10.1016/j.ejcts.2006.10.029
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
Reply to Riquet et al.
Hidehito Matsuoka*
Hyogo Prefectural Kaibara Hospital, 5208-1 Kaibara, Kaibara-cho, Tanba city, Hyogo 669-3395, Japan.
Received 19 October 2006;
accepted 25 October 2006.
* Corresponding author. Tel.: +81 795 72 0524; fax: +81 795 72 1276. (Email: hmatsuoka1{at}mac.com).
Key Words: Octogenarians • Pneumonectomy • Bronchoplasty
My coauthors and I thank Dr Riquet for his suggestive comment on our report [1,2]. I agree with your opinion that our good results were clearly attributable to a strict patients selection and multitudes of peripheral type adenocarcinomas. Histologic pattern difference between Japan and Europe is an interesting and considerable issue [3]. It is understandable that a high proportion of central type squamous cell carcinomas boost the number of pneumonectomy. However we believe that pneumonectomy is a disease in itself and should be avoided at all costs because of the long-term complications that are sometimes associated with pneumonectomy but seldom seen after lobectomy or sleeve lobectomy, that is, the so-called postpneumonectomy syndrome presenting as late pulmonary hypertension or respiratory failure [4]. In our series, four octogenarians (10% of all cases, 25% of lobectomies) were performed sleeve lobectomy with bronchoplasty to avoid pneumonectomy, and had no major complication. We believe that sleeve lobectomy should be applied whenever possible even in octogenarians.
References
- Riquet M, Berna P, das Neves-Pereira J-C, Foucault C. Pulmonary resection in octogenarians. Eur J Cardiothorac Surg 2007;31:141.[Free Full Text]
- Matsuoka H, Okada M, Sakamoto T, Tsubota N. Complication and outcomes after pulmonary resection for cancer in patients 80 to 89 years of age. Eur J Cardiothorac Surg 2005;28:380-383.[Abstract/Free Full Text]
- Shields TW. Pathology of carcinoma of the lung. In: Shields TW, LoCicero III S, Ponn RB, editors. General thoracic surgery. Philadelphia: Lippincott Williams and Wilkins; 2000. pp. 1249-1268.
- Okada M, Tsubota N, Yoshimura M, Miyamoto Y, Matsuoka H, Satake S, Yamagishi H. Extended sleeve lobectomy for lung cancer: the avoidance of pneumonectomy. J Thorac Cardiovasc Surg 1999;118:710-714.[Abstract/Free Full Text]
