Background/Objectives: Sleeve and wedge bronchial resections without removal of lung tissue may represent a surgical option in selected cases of low-grade neoplasms. This study is a retrospective analysis of the surgical technique and the short- and long- term results of bronchial sleeve resections performed in the Department of Thoracic Surgery of Careggi Hospital in Florence, Italy, and in the Department of Thoracic Surgery of Marie Lannelongue Hospital in Plessis Robinson, France.Methods: Between January 2017 and October 2024, 25 patients with low-grade tumors underwent bronchial sleeve resection with total lung-sparing. We collected the preoperative data, surgical techniques, postoperative results and long-term oncologic outcomes.Results: We performed 25 bronchial sleeves which resulted in 20 typical carcinoids (TC), 3 atypical carcinoids (AT) and 2 mucoepidermoid carcinomas. Three patients had R1 resection, and one of them also had N1 disease; a multidisciplinary team opted for a “watch and wait” policy without adjuvant therapies. No local recurrences occurred, although three distant recurrences were observed. The five-year overall survival (OR) rate was 100%; the five-year disease-free survival (DFS) rate was 80%.Conclusions: Bronchoplastic procedures without lung parenchyma resection are an appropriate and feasible technique for selected cases of low-grade endobronchial neoplasms.
背景/目的：对于特定类型的低度恶性肿瘤病例，不切除肺组织的袖状及楔形支气管切除术可作为一种外科治疗选择。本研究回顾性分析了意大利佛罗伦萨Careggi医院胸外科与法国普莱西罗宾逊Marie Lannelongue医院胸外科实施的支气管袖状切除术的手术技术及短期与长期疗效。方法：2017年1月至2024年10月期间，25例低度恶性肿瘤患者接受了完全保留肺组织的支气管袖状切除术。我们收集了患者的术前资料、手术技术、术后结果及长期肿瘤学结局。结果：实施的25例支气管袖状切除术中，病理结果显示20例为典型类癌，3例为非典型类癌，2例为黏液表皮样癌。3例患者存在R1切除，其中1例同时伴有N1病变；多学科团队对此类患者采取"观察等待"策略而未行辅助治疗。研究期间未出现局部复发，但观察到3例远处复发。五年总生存率为100%，五年无病生存率为80%。结论：对于经过筛选的低度恶性支气管内肿瘤病例，不切除肺实质的支气管成形术是一种恰当且可行的外科技术。
Parenchyma-Sparing Bronchial Sleeve Resection in Low-Grade Malignant Diseases
肿瘤(癌症)患者之家