The treatment of bronchial carcinoma by lobectomy and sleeve resection of the main bronchus.

In 1947 Price Thomas performed a bronchotomy and removed a portion of the circumference of the wall of the right main bronchus for an adenoma, performing a plastic repair of the bronchus (Price Thomas, 1956). The patient had a straightforward convalescence, with good primary union of the bronchus, and has continued to make good use of both lungs ever since. The procedure has been repeated with success on several occasions. In 1952 he carried the idea further, in the treatment of a patient with a stricture of the main bronchus, in association with a destroyed tuberculous left upper lobe. In this case, the lower lobe was saved by resecting the stricture and anastomosing the divided ends of the main bronchus. The patient had a positive sputum at the time of operation, and subsequently developed tuberculous endobronchitis at the suture line, spreading distally, so that the pneumonectomy had to be completed. Nevertheless, it had been established that when two ends of a bronchus were