Bronchoplastic procedures including sleeve lobectomy were initially introduced for patients whose pulmonary function was insufficient to tolerate pneumonectomy. In more recent years, sleeve lobectomy has evolved as an alternative to pneumonectomy
in
carefully selected cases of bronchogenic carcinoma, especially for centrally located lesions. Between 1992 and 1995, bronchoplastic procedures for bronchogenic carcinoma were performed in 15 patients and the majority of operative procedures were
sleeve
lobectomy(N=12). All procedures were considered as complete and potentially curative. Mean age was 62.3 years(range 46 to 70 years)and there were 12 males and 3 females. Of 15 patients, 7 underwent right upper sleeve, 2 underwent right lower
sleeve, 5
underwent left upper sleeve, and 1 underwent right sleeve pneumonectomy. Postoperative staging was; stage I in 3, stage II in 8, stage IIIa in 3 and stage IIIb in l. The postoperative complications included anastomosis site obstruction due to
granulation tissue in l, local recurrence in 3, and wound infection in l. There were l operative death due to sepsis and 2 late deaths. The three-year survival rate was 80%. The significant correlation was observed(r=0.71)between the predicted
FEVl(1.851L) and measured FEVl(1.762L).
In conclusion, bronchoplastic procedure will have better prognosis than pneumonectomy in selected lung cancer patients because of preserving good function in remnant lung.
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