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.


CONCLUSIONS
Bronchoplastic procedures without resection of the lung parenchyma are a suitable and fascinating technique for selected cases of low-grade endobronchial neoplasms.
Division of Thoracic Surgery, University of Pisa, Pisa, Italy. m.lucchi@med.unipi.it
Marco
M
Lucchi
Franca
F
Melfi
Alessandro
A
Ribechini
Paolo
P
Dini
Leonardo
L
Duranti
Gabriella
G
Fontanini
Alfredo
A
Mussi
D000328:Adult; D000368:Aged; D001984:Bronchial Neoplasms / Q000473:pathology / Q000601:surgery*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D013536:Suture Techniques; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome