Sleeve and wedge parenchyma-sparing bronchial resections in low-grade neoplasms of the bronchial airway

Objective: Sleeve and wedge bronchial resections without parenchymal resection may represent a surgical option in selected cases of low-grade neoplasms of the airway. We reviewed our experience analyzing the indications, the operative technique, and the results of such operations. Methods: From 1980 to 2006, we performed 248 bronchoplastic procedures, and 26 of those were bronchoplastic procedures without parenchymal resection for low-grade neoplasms of the airway. There were 17 men and 9 women with a mean age of 49.4 years (range 19-74 years). All patients underwent a preoperative bronchoscopic study, which gave indication for such a procedure, and an intraoperative bronchoscopic examination confirming the feasibility and the good quality of the bronchial suture. The bronchial resection involved the trachea and the carina (n = 5), the main bronchi (n = 7), the intermediate bronchus (n = 2), the bronchial corner (n = 6), and the lobar bronchus (n = 6). Results: The resection margins were always tumor free. There was no operative mortality. The mean hospital stay was 6.7 days (range 4-16 days). One minimal dehiscence and no stenosis of the anastomosis were observed. In 1 case we experienced a granulation that required an endoscopic treatment. The histologic type was carcinoid (n = 18), mucoepidermoid (n = 2), adenoid cystic (n = 1), chondroma (n = 2), hamartoma (n = 1), melanoma endobronchial metastasis (n = 1), and glomic tumor (n = 1). The mean follow-up was 134 months and no local relapse occurred. Conclusion: Bronchoplastic procedures without resection of the lung parenchyma are a suitable and fascinating technique for selected cases of low-grade endobronchial neoplasms.