Lobectomy with sleeve resection in the treatment of bronchial tumours.

Bronchial carcinoma, situated at the level of the upper lobe orifices, may be treated surgically by pneumonectomy or lobectomy combined with sleeve reseotion of the main bronchus and end-toend anastomosis of the proximal and distal stumps, thus conserving the remainder of the lung. Many authors have emphasized the safety and wider applicability of sleeve resection. This procedure has a particular place in the management of patients wi,th impaired respiratory function due to pulmonary or cardiac disease and also in older patients in whom pneumonectomy carries an unduly high operative Irisk (Price Thomas, 1956; Johnston and Jones, 1959; be Roux, 1968). We report 46 patients with malignant disease involving the upper or lower lobe orifices treated by sleeve resection by one surgeon (M. P.) at the Brompton Hospital during a 10-year period (19591969). They have been followed up at frequent intervals with repeated clinical and radiological assessments. Simple respiratory function tests have been carried out preand post-operatively in a small group of randomly selected patients to investigate the extent to which they are impaired by surgery.