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Sleeve lobectomy is an established surgical procedure in patients with lung cancer. Usually the only surgical alternative would be a pneumonectomy. This article describes the perioperative risks and functional results in patients after sleeve lobectomy compared to pneumonectomy and typical lobectomy. There were only minor differences with respect to postoperative morbidity comparing the different procedures but the mortality rate was higher following pneumonectomy. Bronchopleural fistula rates were also similar comparing lobectomy and sleeve lobectomy but elevated following pneumonectomy. Bronchovascular fistulas after sleeve lobectomy are potentially life-threatening. Postoperative pulmonary function tests showed similar values for lobectomy and sleeve lobectomy patients and were considerably better than following pneumonectomy. Whenever possible sleeve lobectomy should take preference over pneumonectomy. [ABSTRACT FROM AUTHOR]

The minimally-invasive, thoracoscopic instead of open lobectomy offers attractive prospects to the lung cancer patient, and might be a tempting marketing instrument. However, lung cancer surgery is guided strictly by oncologic principles. The removal of an anatomically resected lobe and specimens of complete compartimental lymphadenectomy are mandatory. Prior to routine implementation, any new procedure, and any modification of access as in the case of VATS (video assisted thoracic surgery) lobectomy has to be rigorously examined for its superiority or at least equivalence compared to the standard procedure. In the case of VATS lobectomy, published evidence is limited to feasibility and safety aspects in selected cases. The assessment of postoperative pain might be systematically biased by a comparison of VATS to posterolateral thoracotomy. Results of mediastinal lymphadenectomy performed with VATS lobectomy are very disappointing and, given the procedure is curatively intended, quite alarming, as oncological procedures should never jeopardise their inherent chance of curation for the sake of a less invasive access. This principle is further challenged by the notoriously long learning curve for VATS lobectomy. To conclude, at present VATS lobectomy might be an option for a minority of selected patients. However, VATS lobectomy is not a routine procedure for early stage lung carcinoma. [ABSTRACT FROM AUTHOR]

The article deals with coping processes which accompany an illness episode of patients undergoing surgical therapy for lung cancer. The main thesis of the investigation is that each severe illness means a life crisis for the patient and that endeavours to support the patient in his/her task of coping with this event have to start from a knowledge of the patient's view of his/her situation. The results of the research - which has been done according to the principles of "grounded theory“ - show a close connection between frequency of complications in the process of the patient's physical recovery following the operation and the patient's view of a) possibilities to influence the further development of the disease through therapy and b) his/her trust in the manageability of the operation by the surgeon as well as by him/herself. [ABSTRACT FROM AUTHOR]