Main bronchial sleeve resection and bronchoplasty without removing lung parenchyma

We applied main bronchial sleeve resections without removing lung parenchyma and bronchoplasty in two patients with metastatic lung cancer and squamous cell carcinoma in situ. Main bronchial sleeve resection without removing lung parenchyma is generally considered technically difficult, as the remaining lung prevents the surgeon from obtaining good operative views; this means that the bronchial anastomosis must be performed in the deep, narrow space of the thorax. However, the two patients showed excellent results. Postoperative bronchoscopy ensured patency of the bronchial lumen in both patients. We believe that the surgeon can obtain a good operative view by resecting Botallo's ligament or by traction of the trachea and main pulmonary artery in cases involving lesions such as polypoid tumors toward the internal lumen of the bronchus, leading to successful results.