Segmental bronchial sleeve resection: preserving all lung parenchyma for benign/low-grade neoplasms

Abstract

Background: Bronchoplastic techniques are used commonly for the surgical treatment of benign or low-grade malignant neoplasms as a means of sparing healthy lung parenchyma. Because of technical difficulties, however, standard lobectomy or segmentectomy procedures are performed for the neoplasms localized in distally located tumors. We present the clinical and surgical data of 12 patients who underwent a unique surgical procedure, called by the authors of this article "segmental bronchial sleeve resection," without any pulmonary resection.

Methods: Twelve patients with benign or low-grade malignant neoplasms who underwent segmental bronchial sleeve resection to totally preserve lung parenchyma between the years 1979 and 2008 were included in the study. Data were gathered from patient records retrospectively.

Results: The postoperative course was uneventful for 10 patients. One of the remaining 2 patients underwent rethoracotomy because of hemorrhage, and tracheostomy was performed for the other patient because of persistent atelectasis. There was no mortality for any of the patients.

Conclusions: Segmental bronchial sleeve resection is complex in technique and may have an increased risk of complications compared to a standard sleeve resection, but it is an effective and safe bronchoplastic technique for selected patients with benign or low-grade malignant bronchial tumors when performed carefully by an experienced surgeon.