Upper Lobectomy with Sleeve Resection of the Main Bronchus

This procedure is used to conserve functioning lung tissue when tumour extends into the junction of the upper lobe bronchus with the main bronchus (Fig. 37.1). The procedure is more suited for the right upper lobe because the intermediate bronchus has sufficient length and circumference to allow a satisfactory anastomosis to the main bronchus. This is not always the case on the left side, and although it is possible, the early origin of the lower lobe segmental bronchi and the rapid tapering of the main bronchus may render it difficult.