When Conventional Hilar Dissection Is Not Feasible: Intrapericardial Lobectomy for Non-Small Cell Lung Cancer
Year: 2026
Type: article
Abstract: Intrapericardial vascular control may be required during lobectomy for centrally located tumors or when conventional hilar dissection cannot be performed safely. However, evidence specifically addressing intrapericardial vascular control at the lobectomy level remains limited. This retrospective single-center study included 29 consecutive patients who underwent intrapericardial lobectomy for non-small cell lung cancer between January 2010 and December 2025. Indications for intrapericardial vascular control, perioperative outcomes, resection status, overall survival (OS), and disease-free survival (DFS) were evaluated. OS and DFS were estimated using the Kaplan–Meier method, and median follow-up was calculated using the reverse Kaplan–Meier method. The mean age was 59.6±8.2 years, and 89.7% of patients had received neoadjuvant treatment. The indication for intrapericardial vascular control was tumor-related hilar or vascular involvement in 58.6%, unsafe extrapericardial dissection in 31.0%, and treatment-related hilar or mediastinal fibrosis in 10.3%. R0 resection was achieved in 89.7% of patients. Postoperative complications occurred in 44.8%, with major morbidity in 24.1% and 30-day mortality in 3.4%. No cardiac tamponade or cardiac herniation occurred. At a median follow-up of 87 months, median OS was 64 months, and 5-year OS was 52.9%. Median DFS was 21 months, with a 5-year DFS of 40.2%. Intrapericardial vascular control may provide a useful technical option when conventional hilar dissection is unsafe or proximal vascular control is required, allowing lobectomy to be completed with a high rate of complete resection and acceptable perioperative outcomes.
Institution: Bursa Uludağ Üni̇versi̇tesi̇
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225620889