Complicated bronchoplasty for lung cancer--its significance in salvaging a few segments of lung

We performed bronchial reconstruction by several unusual procedures and succeeded in preserving lung function, which was proven with spirometry and treadmill exercise test. Type 1 (n = 2): Anastomosis between the left main bronchus and upper segmental bronchus with lower lobectomy and lingulectomy. Type 2 (n = 2): Anatomosis between the left main bronchus and basal segmental bronchus with upper lobectomy and superior segmentectomy acompanied by vascular reconstruction. Type 3 (n = 4): Anastomosis between the right main bronchus and lower bronchus with upper and middle lobectomy, accompanied by vascular reconstruction in 2 cases. One patient required completion pneumonectomy but the others had uneventful postoperative courses and maintained better lung function than expected, although the amount of preserved lung tissue was limited. There may be a great difference in the postoperative quality of life if pneumonectomy can be avoided, even though the preserved segments are few. Surgeons should reconsider the choice of pneumonectomy for interlobar tumors invading another lobe, especially in the case of N0 or N1 squamous cell carcinoma.