Sleeve lobectomy (lobectomy and bronchoplasty) for bronchial carcinoma

We present a series of 90 patients who underwent sleeve lobectomy for malignant bronchial tumors at the Brompton Hospital, London, between 1964 and 1974. The operative mortality was low (1%), and technical complications were infrequent. Bronchial stenosis, which occurred in 6% of patients, was due to recurrence of tumor in 4% and cicatrization in 2%. The majority of patients had squamous cell carcinomas of the upper lobe (76/90). In this group, the 5-year survival was 71% when the hilar lymph nodes were clear of tumor at the time of operation and 17% when the hilar lymph nodes were involved. Because these 5-year survival figures suggest that tumor-free survival is not significantly compromised by this conservative approach, we believe that sleeve lobectomy rather than pneumonectomy should be considered the operation of choice for squamous cell carcinomas of the upper lobe orifice involving the main bronchus.