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Yunus Aksoy



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    P1.14 - Thymoma/Other Thoracic Malignancies (Not CME Accredited Session) (ID 946)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.14-09 - Outcome After Lung Resection for Primary Lung Carcinomas/Metastasis in Patients with Performed Total Laryngectomy for Laryngeal Carcinoma (ID 14159)

      16:45 - 18:00  |  Author(s): Yunus Aksoy

      • Abstract

      Background

      Total laryngectomy remains the treatment of choice for recurrent / persistent laryngeal carcinoma after radiotherapy or chemoradiotherapy. These patients with laryngeal carcinoma are at risk for developing both pulmonary metastasis and second primary lung cancer. Because of the persistent tracheostomy, postoperative management after lung resection is usually a difficult process. Ineffective evaluation of preoperative pulmonary functions, failure of single lung ventilation due to short trachea, inadequate respiratory physiotherapy are frequently encountered problems. The purpose of this study is to evaluate the outcomes of lung resection in patients with persistent tracheostomy due to laryngeal carcinoma.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Between Jan 2006- Jan 2016, the data of 9247 patients who underwent lung resection at three different centers were retrospectively examined. The study group consisted of 68 patients (62 male, mean age 59.49 ± 11.4 (31-82)) who had persistent tracheostomy due to laryngeal carcinoma. Patient preoperative evaluation parameters, operation techniques, postoperative complications and survival were analyzed.

      4c3880bb027f159e801041b1021e88e8 Result

      The mean time between the two operations was 55.68 ± 64.8 (3-312) months. Pulmonary tumors were located in the upper lobe in 53 patients (77.9%), in the lower lobe in 11 patients (16.1%), in the middle lobe in 2 patients (3%) and bilaterally in 2 patients (3%). Lung resection was performed with thoracotomy in 53 patients (78%) and videothoracoscopy in 15 patients (22%). Extent of lung resection was sublobar resection in 28 patients (41.2%), lobectomy in 37 patients (54.4%) and pneumonectomy in 3 patients (4.4%). Histopathological examination revealed squamous cell carcinoma in 53 (78%) patients and other non-small cell lung carcinomas in 15 (22%) patients. Postoperative complications were present in 24 patients (35.3%). The most common complications observed were prolonged air leak in 7 patients (10,3%), space in 6 patients (8.8%) and pneumonia in 5 patients (7.3%). Mortality was seen due to respiratory insufficiency in 2 (2.9%) patients who underwent right lower bilobectomy and right pneumonectomy. The 5-year survival rate after lung resection was 31.6% and the median follow-up time was 32 months ± 8.45.

      8eea62084ca7e541d918e823422bd82e Conclusion

      This study shows that the presence of a tracheostomy should not be considered a risk factor for pulmonary resection if there is close cooperation between pulmonary medicine, anesthesia and thoracic surgery clinics. In these patients, besides other lung resections, videothoracoscopic lung resections can be performed safely and good oncologic results can be obtained.

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