Background. We analyzed the association between
neoadjuvant chemoradiation in patients undergoing
bronchial sleeve resection with the incidence of postoperative pulmonary and airway complications.
Methods. After instructional review board approval we
performed a retrospective review of a prospectively
maintained database of 136 patients who underwent
sleeve resection in our institution between January 1998
and December 2016. Administration of neoadjuvant chemoradiation treatment was the studied exposure. Outcomes of interest were rates of postoperative pulmonary
and airway complications. Nonparametric testing of demographic, surgical, and pathologic characteristics and
morbidity was performed. Logistic regression models
evaluated postoperative pulmonary complications and
airway complications. Analysis was performed using
Stata/IC 15.
Results. We analyzed 136 patients (18 underwent neoadjuvant chemoradiation), 77 (57%) of whom had nonsmall cell lung cancer. Postoperative pulmonary complications were observed in 44 of 136 patients (32%).
Incidences of pulmonary complications were higher in
the neoadjuvant chemoradiation group compared with
the non–neoadjuvant radiation group (15/18 patients
[83%] vs 29/118 patients [25%], respectively; P < .001).
Likewise, rates of pneumonia, atelectasis, respiratory
insufficiency, bronchial stenosis, prolonged air leak,
bronchopleural fistula, and completion pneumonectomy
(2/18 [11%]) were higher in the neoadjuvant chemoradiation group, reaching statistical significance in all
cases except bronchial stenosis and prolonged air leak.
Only neoadjuvant chemoradiation therapy remained
significant for postoperative pulmonary and airway
complications on logistic regression (both P < .05)
Conclusions. Patients who undergo neoadjuvant chemoradiation before sleeve resection are at an increased
risk of pulmonary and airway complications