Sleeve basal segmentectomy with pulmonary artery division for lung cancer: how to do it

Sleeve segmentectomy was originally developed to preserve the lung volume in patients who were unable to tolerate lobectomy. We herein report an immunocompromised patient with potentially curable peripheral squamous cell carcinoma in whom sleeve basal segmentectomy was performed for a 1.8-cm tumor with endobronchial growth that occluded B7 and invaded the inlet of the middle lobar bronchus and B6. To provide sufficient surgical exposure for complex double-barrel reconstruction after segmentectomy, A6 was divided and reconstructed after the anastomosis was complete. This technique may be applicable to other peripheral bronchial reconstructions to minimize blood flow disruption to bronchial anastomosis.