Resection with reconstruction of central airways to preserve lungs
Two of the more significant developments in the surgery of lungs and airways over the last 20–25 years have been the evolution of techniques for the removal of neoplasms involving the carina and the application of techniques of “sleeve resection” of the bronchi in treatment of bronchial neoplasms in order to conserve lung tissue. Within this period of time there has been a gradual evolution of methods for removal of neoplasms involving the carina with promise of cure, progressively more acceptable risk, and conservation of as much lung tissue as possible. Over the same period of time, sleeve resection, limiting the removal of lung tissue in most cases to one lobe, has moved from being an operation performed in patients who could not tolerate a pneumonectomy to one which is applied electively on careful indications as a procedure of choice. It is the thoracic surgeon’s hope that advances in the systemic treatment of neoplasms of the airways and lung will in future days permit an increasingly successful application of these techniques. We shall consider these two approaches separately.
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