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Ann Thorac Surg 1996;62:824-828
© 1996 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Bronchoplasty in the Management of Low-Grade Airway Neoplasms and Benign Bronchial Stenoses

General Thoracic Surgical Unit, Massachusetts General Hospital, and Department of Surgery, Harvard Medical School, Boston, Massachusetts

See also page 828

Background. Parenchyma-sparing bronchoplastic procedures have altered the management of benign bronchial stenoses and low-grade neoplasms of the airway. Reliable techniques are available to allow sleeve resection of any lobe or the main bronchus and thus maximize preservation of lung parenchyma.

Methods. Between 1972 and 1995 we performed 100 bronchoplastic procedures on 99 patients. Seventy-eight patients had low-grade or benign tumors including carcinoid, mucoepidermoid, and fibrous histiocytomas. Seven patients had inflammatory lesions including histoplasmosis and tuberculosis. Two patients had idiopathic stenosis. Thirteen patients had stenoses due to prior trauma or previous operation. Resection involved the bronchus alone in 51 cases. Sleeve lobectomies were done in 49 patients.

Results. There were two postoperative deaths in complicated patients. Major complications occurred in 3 patients. Sixteen patients presented preoperatively with postobstructive pneumonia but had no major postoperative complications. Long-term follow-up (mean, 88 months) reveals only one instance of tumor recurrence (adenoidcystic carcinoma) and progressive stenosis in 1 patient with idiopathic stenosis.

Conclusions. Lung-sparing bronchoplastic operations are the procedures of choice in anatomically suited patients with low-grade malignant tumors of the airway and benign bronchial stenosis.

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Discussion
Ann. Thorac. Surg. 1996 62: 828-829. [Extract] [Full Text]

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