Right side sleeves

Right bronchial sleeve resection is a demanding surgical technique that is applied in case of lung tumors or lymph nodes invading the origin of the right lobar bronchus. Sometimes the tumor invades also the pulmonary artery (PA) and in this instance, a vascular resection and reconstruction of the artery may be required. On the right side, the most frequent bronchoplastic procedure is the upper lobe sleeve resection with the anastomosis of the mainstem bronchus with the bronchus intermedius. Exceptionally, a middle lobe sleeve resection or a sleeve bilobectomy may be required. In every case, the technique of the bronchoplasty includes the anastomosis between the two bronchial stumps with two running sutures with a non-absorbable monofilament obtaining a telescopic anastomosis. In case of PA involvement, an angioplasty may be associated. In this review we report our experience in treating lung cancer infiltrating the origin of the upper bronchus, the middle bronchus and the intermediate bronchus requiring resection and reconstruction describing the surgical anatomy of right bronchial and vascular tree, and illustrating in details our surgical technique of bronchoplasty.