Reconstruction of pulmonary artery by autologous pericardium or azygous venae for non-small cell lung cancer

Objective To review the clinical experience of reconstruction of pulmonary artery(PA) by a pateh of autologus pericardium or azygous venae for non-small cell lung cancer. Methods Between March 1992 and August 2009, 62 patients with locally advanced central lung cancer received sleeve resection and reconstruction of PA. According to PTNM classification, 4 patients were in stage Ⅱb, 46 in stage Ⅲa and 12 in stage Ⅲb. 17 patients had induction chemothoerapy. Sleeve lotrate the PA, the surgical procedures included partial PA tangential resections and reconstructions by a pateh of autologous azygous venas in 18 cases , a patch of autologous pericardium in 38 cases and a complete PA sleeve resection reconstructios by a custom-made autologous pericardial conduit interposition in 6 cases. Partial superior vena cava tangential resctions and reconstructions were performed in 5 patients by a patch of autologous pericardium or azygous venae. 47 patients received pstoperative chemotherapy and 19 had radiotherapy. Results There was 2 early postoperative deaths(3.2%). The cause of death was bronchial anastomotic leak led to respiratory failure in 1 case and severe arrhmia led to heart arrest in 1. No cancerous tissue of all resection margins are checked by frzen section histology and examination of resection specimens in the surgical pathology laboratory. The postoperative complications occurred in 11 patients(17.7%) and all of them recovered uneventfully.Roentgenography, flexible bronchoscopy and echocardiography were in normal range in the remaining 60 patients with no bronchial anastomosis stenosis or vascular thombosis before discharge and at 2-6 months after surgery. The mean follow up time was 49.5 months (6-210 months). The overall 1, 3, 5 and 10 yerr survival rates were 80.2%, 44.7% ,31.4% and 23. 1%, respectively. Conclusion Reonstruction of PA by autologous pericardial patch or autologous azygos vein patch is a safe and effective technique for locally advanced lung cancer.For extended circumferential defects of PA,the autologous pericardial conduit interposition could bue used for reconstruction. Key words: Pulmonary artery; Pericardium; Tissue transplantation ; Transplantation autologous; Lung neoplasms