Skip to main content
SpringerLink
Log in

History and current status of bronchoplastic surgery for lung cancer

  • Guest Review Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Sleeve lobectomy for carcinoma of the lung was first described as a compromised operation for patients whose pulmonary reserve was considered inadequate to permit pneumonectomy. Since then, many authors have suggested that bronchoplasties may provide as good if not better results than pneumonectomy in selected cases of primary carcinoma of the lung involving the proximal bronchial tree. In all reported series, lesions in the hilum of the right upper lobe are the commonest indication for sleeve lobectomy, although all lobes and segments of the lungs may on occasion be involved with tumors that are amenable to some form of lung-sparing bronchoplastic procedure. As a general statement, bronchoplasties should be considered in any case of lung cancer that can be completely resected by these techniques although some controversy persists about the application of these procedures in patients with N1 or N2 disease. Published reports document a 30-day operative mortality of 0%–5%. Complications peculiar to sleeve lobectomy are an increased incidence of retained secretions, bronchovascular fistulas, and a potential for an increased incidence of local recurrence. Most major reports document a 5-year survival of 40%–50% and functional results that are significantly better than those obtained following pneumonectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Price Thomas C. Conservative resection of the bronchial tree: a lecture delivered before the Fellows of the College in October 1955. J R Coll Surg Edinb 1956;1:169–186.

    Google Scholar 

  2. Johnston JB, Jones PH. The treatment of bronchial carcinoma by lobectomy and sleeve resection of the main bronchus. Thorax 1959;14:48–54.

    Article  PubMed  CAS  Google Scholar 

  3. Allison PR. Personal communication. Quoted by Johnston JB, Jones PH. The treatment of bronchial carcinoma by lobectomy and sleeve resection of the main bronchus. Thorax 1959;14:49.

    Google Scholar 

  4. Paulson DL, Shaw RR. Preservation of lung tissue by means of bronchoplastic procedure. Am J Surg 1955;89:347–355.

    Article  PubMed  CAS  Google Scholar 

  5. Paulson DL, Shaw RR. Results of bronchoplastic procedures for bronchogenic carcinoma. Ann Surg 1960;151:729–740.

    Article  PubMed  CAS  Google Scholar 

  6. Faber LP, Jensik RJ, Kittle CF. Results of sleeve lobectomy for bronchogenic carcinoma in 101 patients. Ann Thorac Surg 1984;37:279–285.

    PubMed  CAS  Google Scholar 

  7. Jensik RJ, Faber LP, Kittle CF. Sleeve lobectomy for bronchogenic carcinoma: the Rush-Presbyterian-St. Luke’s Medical Center experience. Int Surg 1986;71:207–210.

    PubMed  CAS  Google Scholar 

  8. Vogt-Moykopff I, Fritz TH, Meyer G. Bronchoplastic and angioplastic operation in bronchial carcinoma: long-term results of a retrospective analysis form 1973 to 1983. Int Surg 1986;7:211–220.

    Google Scholar 

  9. Nohl HC. An investigation into the lymphatic and vascular spread of carcinoma of the bronchus. Thorax 1956;11:172–185

    Article  PubMed  CAS  Google Scholar 

  10. Tsubota N. Bronchoplasty at the level of the segmental bronchus. Semin Thorac Cardiovasc Surg 2006;18:96–103.

    Article  PubMed  Google Scholar 

  11. Martin-Ucar AE, Chandhuri N, Edwards JG, Waller DA. Can pneumonectomy for non-small cell lung cancer be avoided? An audit of parenchymal lung surgery. Eur J Cardiothorac Surg 2002;21:601–605.

    Article  PubMed  CAS  Google Scholar 

  12. Deslauriers J, Grégoire J, Jacques LF, Piraux M, Guojin L. Lacasse Y. Sleeve lobectomy versus pneumonectomy for lung cancer: a comparative analysis of survival and sites of recurrences. Ann Thorac Surg 2004;77:1152–1156.

    Article  PubMed  Google Scholar 

  13. Rendina EA, Venuta F, de Giacomo T, Rossi M, Coloni GF. Parenchymal sparing operation for bronchogenic carcinoma. Surg Clin North Am 2002;82:589–609.

    Article  PubMed  Google Scholar 

  14. Okada M, Yamagishi H, Satake S, Matsuoka H, Miyamoto Y, Yoshimura M, et al. Survival related to lymph node involvement in lung cancer after sleeve lobectomy compared with pneumonectomy. J Thorac Cardiovasc Surg 2000;119:814–819.

    Article  PubMed  CAS  Google Scholar 

  15. Okada M, Tsubota N, Yoshimura M, Miyamoto Y, Matsuoka H, Satake S, et al. Extended sleeve lobectomy for lung cancer: the avoidance of pneumonectomy. J Thorac Cardiovasc Surg 1999;118:710–714.

    Article  PubMed  CAS  Google Scholar 

  16. Lowe JE, Bridgman AH, Sabiston DC. The role of bronchoplastic procedures in the surgical management of benign and malignant pulmonary lesions. J Thorac Cardiovasc Surg 1982;83:227–234.

    PubMed  CAS  Google Scholar 

  17. Weisel RD, Cooper JD, Delarue NC, Theman TE, Todd TR, Pearson FG. Sleeve lobectomy for carcinoma of the lung. J Thorac Cardiovasc Surg 1979;79:839–849.

    Google Scholar 

  18. Kesler KA, Conces DJ Jr, Heimansohn DA, Mathur P. Assessing the feasibility of bronchoplastic surgery with magnetic resonance imaging. Ann Thorac Surg 1991;52:145–147.

    Article  PubMed  CAS  Google Scholar 

  19. Suri RM, Keshavjee SH, Herman S, Sniderman K, Pearson FG. Pulmonary arteriography for the assessment of technical feasibility of sleeve resection in lung cancer. Ann Thorac Surg 1997;63:800–805.

    Article  PubMed  CAS  Google Scholar 

  20. Rea F, Loy M, Bortohotti L, Feltracco P, Fiore D, Sartori F. Morbidity, mortality, and survival of the bronchoplastic procedures for lung cancer. Eur J Cardiothorac Surg 1997;11:201–205.

    Article  PubMed  CAS  Google Scholar 

  21. Rendina EA, Venuta F, Ricci C. Effects of low-dose steroids on bronchial healing after sleeve resection. J Thorac Cardiovasc Surg 1992;104:888–889.

    PubMed  CAS  Google Scholar 

  22. Krüger M, Uschinsky K, Häbler K, Engelmann C. Post operative complications after brochoplastic procedures in the treatment of bronchial malignancies. Eur J Cardiothoracic Surg 1998;14:46–53.

    Article  Google Scholar 

  23. Rendina EA, Venuta F, Ciriaco P, Ricci C. Bronchovascular sleeve resection: technique, perioperative management, prevention, and treatment of complications. J Thorac Cardiovasc Surg 1993;106:73–79.

    PubMed  CAS  Google Scholar 

  24. Watanabe Y, Shimizu J, Oda M, Hayashi Y, Watanabe S, Yazaki U, et al. Results in 104 patients undergoing bronchoplastic procedures for bronchial lesions. Ann Thorac Surg 1990;50:607–614.

    PubMed  CAS  Google Scholar 

  25. Van Schil PE, de la Rivière AB, Knaepen PJ, van Swieten HA, Reher SW, Goossens DJ, et al. Long-term survival after bronchial sleeve resection: univariate and multivariate analysis. Ann Thorac Surg 1996;61:1087–1091.

    Article  PubMed  Google Scholar 

  26. Deslauriers J, Tronc F, Grégoire J. Survival in patients undergoing sleeve resection for lung cancer. Unpublished personal series.

  27. Nagayasu T, Matsumoto K, Tagawa T, Nakamura A, Yamasaki N, Nanashima A. Factors affecting survival after bronchoplasty and broncho-angioplasty for lung cancer: single institutional review of 147 patients. Eur J Cardiothorac Surg 2006;29:585–590.

    Article  PubMed  Google Scholar 

  28. Yildizeli B, Fadel E, Mussot S, Fabre D, Chataigner O, Dartevelle PG. Morbidity, mortality and long-term survival after sleeve lobectomy for non-small cell lung cancer. Eur J Cardiothorac Surg 2007;31:95–102.

    Article  PubMed  Google Scholar 

  29. Icard PH, Regnard JF, Guibert L, Magdeleinat P, Jauffret B, Levasseur P. Survival and prognostic factors in patients undergoing parenchymal saving bronchoplastic operations for primary lung cancer: a series of 110 consecutive cases. Eur J Cardiothorac Surg 1999;15:426–432.

    Article  PubMed  CAS  Google Scholar 

  30. Van Schil PE, Vankeirsbilck J, de la Rivière AB, van den Bosch JM. Long-term survival after bronchial sleeve resection in relation to nodal involvement. Eur J Cardiothorac Surg 2000;17:196–197.

    Article  Google Scholar 

  31. Kim YT, Kang CH, Sung SW, Kim JH. Local control of disease related to lymph node involvement in non-small cell lung cancer after sleeve lobectomy compared with pneumonectomy. Ann Thorac Surg 2005;79:1153–1161.

    Article  PubMed  Google Scholar 

  32. Bagan P, Berna P, Perira JC, Le Pimpec Barthes F, Foucault C, Dujon A, et al. Sleeve lobectomy versus pneumonectomy: tumor characteristics and comparative analysis of feasibility and results. Ann Thorac Surg 2005;80:2046–2050.

    Article  PubMed  Google Scholar 

  33. Massard G, Kessler R, Gasser B, Ducrocq X, Elia S, Gouzou S, et al. Local control of disease and survival following bronchoplastic lobectomy for non-small cell lung cancer. Eur J Cardiothorac Surg 1999;16:276–282.

    Article  PubMed  CAS  Google Scholar 

  34. Wood PB, Gildag D, Ilves R, Rae S, Pearson FG. A comparison of gas exchange after simple lobectomy and lobectomy with sleeve resection in dogs. J Thorac Cardiovasc Surg 1974;568:646–652.

    Google Scholar 

  35. Deslauriers J, Gaulin P, Beaulieu M, Piraux M, Bernier R, Cormier Y. Long-term clinical and functional results of sleeve lobectomy for primary lung cancer. J Thorac Cardiovasc Surg 1986;92:871–879.

    PubMed  CAS  Google Scholar 

  36. Khargi K, Duurkens VAM, Verzijlbergen FF, Huysmans HA, Knaepen PJ. Pulmonary function after sleeve lobectomy. Ann Thorac Surg 1994;57:1302–1304.

    PubMed  CAS  Google Scholar 

  37. Angeletti CA, Janni A, Macchiarini P, Ricagna F, Pistelli G. Functional results of bronchial sleeve lobectomy. Eur J Cardiothorac Surg 1991;5:410–413.

    Article  PubMed  CAS  Google Scholar 

  38. Ferguson M, Lehman AG. Sleeve lobectomy or pneumonectomy: optimal management strategy using decision analysis technique. Ann Thorac Surg 2003;76:1782–1788.

    Article  PubMed  Google Scholar 

  39. Tsubota N, Yoshimura M, Murotani A, Miyamoto Y, Matoba Y. Atypical bronchoplasty for lung cancer and benign bronchial disease. Toboku J Exp Med 1994;172:209–220.

    Article  CAS  Google Scholar 

  40. Tsubota N. Bronchoplasty at the level of the segmental bronchus. Semin Thorac Cardiovasc Surg 2006;18:96–103.

    Article  PubMed  Google Scholar 

  41. Kotoulas C, Lazopoulos G, Foroulis C, Konstantinou M, Tomos P, Lioulias A. Wedge resection of the bronchus: an alternative bronchoplastic technique for preservation of lung tissue. Eur J Cardiothorac Surg 2001;20:679–693.

    Article  PubMed  CAS  Google Scholar 

  42. Khargi K, Duurkens VAM, Versteegh MMI. Pulmonary function and postoperative complications after wedge and flap reconstruction of the main bronchus. J Thorac Cardiovasc Surg 1996;112:117–123.

    Article  PubMed  CAS  Google Scholar 

  43. Suen HC, Meyers BF, Guthrie T, Pohl MS, Sundaresan S, Roper CL, et al. Favorable results after sleeve lobectomy or bronchoplasty for bronchial malignancies. Ann Thorac Surg 1999;67:1557–1562.

    Article  PubMed  CAS  Google Scholar 

  44. Gaissert HA, Mathisen DC, Moncure AC, Hilgenberg AD, Grillo HC, Wain JC. Survival and function after sleeve lobectomy for lung cancer. J Thorac Cardiovasc Surg 1996;111:948–953

    Article  PubMed  CAS  Google Scholar 

  45. Yoshino C, Yokoyama H, Yano T, Ueda T, Takai E, Mizutani K, et al. Comparison of the surgical results of lobectomy with bronchoplasty and pneumonectomy for lung cancer. J Surg Oncol 1997;64:32–35.

    Article  PubMed  CAS  Google Scholar 

  46. Ludwig C, Stoelben E, Olschewski M, Hasse J. Comparison of morbidity, 30-day mortality, and long-term survival after pneumonectomy and sleeve lobectomy for non-small cell lung carcinoma. Ann Thorac Surg 2005;79:968–975.

    Article  PubMed  Google Scholar 

  47. Takeda SI, Maeda H, Koma M, Matsubara Y, Sawabata N, Inoue M, et al. Comparison of surgical results after pneumonectomy and sleeve lobectomy for non-small cell lung cancer: trends overtime and 20-year institutional experience. Eur J Cardiothorac Surg 2006;29:276–280.

    Article  PubMed  Google Scholar 

  48. Paulson DL, Urschel HC, McNamara JJ, Shaw RR. Bronchoplastic procedures for bronchogenic carcinoma. J Thorac Cardiovasc Surg 1970;59:38–48.

    PubMed  CAS  Google Scholar 

  49. Jensik RJ, Faber LP, Milloy FJ, Amato JJ. Sleeve lobectomy for carcinoma: a ten-year experience. J Thorac Cardiovasc Surg 1972;64:400–412.

    PubMed  CAS  Google Scholar 

  50. Rendina EA, Venuta F, de Giacomo T. Sleeve resection after induction therapy. Thorac Surg Clin 2004;14:191–197.

    Article  Google Scholar 

  51. Burfeind WR, D’Amico TA, Toloza EM, Wolfe WG, Harpole DH. Low morbidity and mortality for bronchoplastic procedures with and without induction therapy. Ann Thorac Surg 2005;80:418–422.

    Article  PubMed  Google Scholar 

  52. Veronesi G, Solli PG, Leo F, D’Aluto M, Pelosi G, Leon ME, et al. Low morbidity of bronchoplastic procedures after chemotherapy for lung cancer. Lung Cancer 2002;356:91–97.

    Article  Google Scholar 

  53. Ohta M, Sawabata N, Maeda H, Matsuda H. Efficacy and safety of tracheobronchoplasty after induction therapy for locally advanced lung cancer. J Thorac Cardiovasc Surg 2003;125:96–100.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut Universitaire de Cardiologie et de Pneumologie de l’Université Laval, 2725 Chemin Sainte-Foy, Quebec, Que., Canada, G1 V 4G5

    Jean Deslauriers, François Tronc & Jocelyn Grégoire

Authors
  1. Jean Deslauriers
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. François Tronc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jocelyn Grégoire
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean Deslauriers.

Additional information

This review was submitted at the inviation of the editorial committee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Deslauriers, J., Tronc, F. & Grégoire, J. History and current status of bronchoplastic surgery for lung cancer. Gen Thorac Cardiovasc Surg 57, 3–9 (2009). https://doi.org/10.1007/s11748-008-0316-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-008-0316-x

Key words

Search

Navigation