HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Robert J. Cerfolio Claude Deschamps Mark S. Allen Victor F. Trastek Peter C. Pairolero Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cerfolio, R. J. Articles by Pairolero, P. C. Search for Related Content PubMed PubMed Citation Articles by Cerfolio, R. J. Articles by Pairolero, P. C. Related Collections Related Article

Ann Thorac Surg 1996;61:1458-1462
© 1996 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

Mainstem Bronchial Sleeve Resection With Pulmonary Preservation

Section of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota

Background. Resection of a mainstem bronchus with pulmonary preservation is a therapeutic option when disease is limited to the mainstem bronchus. We reviewed our experience with this procedure to determine the operative morbidity, mortality, and long-term outcome.

Methods. From January 1965 through January 1995, 22 patients (13 male, 9 female) underwent circumferential mainstem bronchial sleeve resection without removal of pulmonary parenchyma. Median age was 37 years (range, 12 to 70 years). The right mainstem bronchus was involved in 12 patients and the left, in 10. Nineteen patients (86%) were symptomatic; symptoms included cough in 5, dyspnea in 5, wheeze in 3, hemoptysis in 3, and a combination of these in 3. Conventional tomography was done in 8 patients and identified every lesion. Bronchoscopy was diagnostic in all patients. Resection was for cancer in 15 patients (68%), benign stricture in 5 (23%), and an impacted broncholith in 2 (9%). The cancer was a carcinoid in 9 patients, a mucoepidermoid carcinoma in 3, squamous cell carcinoma in 2, and adenoid cystic carcinoma in 1. Fourteen patients were postsurgically classified as stage IIIA (T3 N0 M0) and 1 patient as stage IIIB (T4 N2 M0). The median length of the resected bronchus was 2.0 cm (range, 1.0 to 4.0 cm). Two patients required hilar release maneuvers. The bronchial anastomosis was reinforced with pleura in 10 patients, pericardium in 2, and serratus anterior muscle in 1.

Results. There were no operative deaths. Three patients (14%) had postoperative complications. Follow-up was complete and ranged from 6 months to 25.7 years (median follow-up, 10.2 years). Twenty-one patients are currently alive. All patients are asymptomatic except 1 patient, who required a stent for an anastomotic stricture. No patient has had recurrence of cancer.

Conclusions. In properly selected patients, mainstem bronchial sleeve resection with lung preservation can be performed safely and provides excellent relief of symptoms with good long-term survival.

Related Article

Discussion
Ann. Thorac. Surg. 1996 61: 1462-1463. [Extract] [Full Text]

This article has been cited by other articles:

				F. Rea, G. Rizzardi, A. Zuin, G. Marulli, S. Nicotra, R. Bulf, M. Schiavon, and F. Sartori Outcome and surgical strategy in bronchial carcinoid tumors: single institution experience with 252 patients Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 186 - 191. [Abstract] [Full Text] [PDF]

				Two-staged treatment of bronchial carcinoid without pulmonary parenchymal resection. J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 753 - 754.

				M. Mezzetti, F. Raveglia, T. Panigalli, L. Giuliani, F. Lo Giudice, S. Meda, and S. Conforti Assessment of outcomes in typical and atypical carcinoids according to latest WHO classification Ann. Thorac. Surg., December 1, 2003; 76(6): 1838 - 1842. [Abstract] [Full Text] [PDF]

				C. F. Thomas Jr., H. D. Tazelaar, and J. R. Jett Typical and Atypical Pulmonary Carcinoids : Outcome in Patients Presenting With Regional Lymph Node Involvement Chest, April 1, 2001; 119(4): 1143 - 1150. [Abstract] [Full Text] [PDF]

				E. Yatsuyanagi, S. Hirata, K. Yamazaki, T. Sasajima, and Y. Kubo Anastomotic complications after bronchoplastic procedures for nonsmall cell lung cancer Ann. Thorac. Surg., August 1, 2000; 70(2): 396 - 400. [Abstract] [Full Text] [PDF]

				G. Massard, P. Thomas, P. Fuentes, and J.-M. Wihlm Reply Ann. Thorac. Surg., November 1, 1998; 66(5): 1870 - 1871. [Full Text] [PDF]

				X. Ducrocq, P. Thomas, G. Massard, P. Barsotti, R. Giudicelli, P. Fuentes, and J.-M. Wihlm Operative Risk and Prognostic Factors of Typical Bronchial Carcinoid Tumors Ann. Thorac. Surg., May 1, 1998; 65(5): 1410 - 1414. [Abstract] [Full Text] [PDF]