J.Jpn. Surg. Soc.. 117(4): 283-288, 2016

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Feature topic

BRONCHOPLASTY FOR LUNG CANCER

Bronchoplasty for patients with lung cancer is basically designed to achieve radical cure with the preservation of lung function. Functional lung parenchyma can be preserved, and the reimplanted lobes contribute to postoperative quality of life. Pneumonectomy is associated with a higher occurrence of postoperative complications, poor quality of life, and cardiopulmonary dysfunction as compared with lobectomy. In addition, long-term complications (i.e., late pulmonary hypertension, respiratory failure, or so-called postpneumonectomy syndrome) are sometimes seen after pneumonectomy but seldom after lobectomy. Thus pneumonectomy itself is considered a disease. Sleeve lobectomy, or lobectomy with bronchoplasty, which allows the preservation of functional lung parenchyma with the possible advantages of lower mortality and morbidity rates, is a valid alternative to pneumonectomy and has recently been accepted as a standard treatment in noncompromised patients with lung cancer. Atypical bronchoplasties such as double-sleeve and extended-sleeve lobectomy, and sleeve segmentectomy are also performed at present. This article describes the surgical techniques for bronchoplastic procedures and compares the surgical outcomes of sleeve lobectomy with those of pneumonectomy reported in the literature.

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