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A guiding philosophy in the management of resectable lung cancer at Stanford is to avoid pneumonectomy if at all possible. This approach can only be practiced by surgeons skilled in sleeve lobectomy and experienced enough to know when lobectomy will provide an equivalent chance of cure as the more morbid pneumonectomy. Avoidance of complete removal of a lung reduces both early complications and long-term disability due to shortness of breath.
Sleeve lobectomy is the removal of a complete lobe of the lung as well as part of the airway that conducts air to the remaining lobe, and then re-connecting that airway and remaining lobe. This more complex procedure may avoid the need for pneumonectomy.
Sleeve lobectomy is possible when a tumor involves the origin (take-off) of the airway that supplies a lobe of the lung. Most surgeons perform removal of the entire lung in this circumstance, because they are not experience in performing sleeve lobectomy. Sleeve lobectomy allows complete removal of the tumor without complete removal of the lung. This is made possible by removing a small portion of the airway that conducts air to the remaining lobe(s), then reattaching that airway and the remaining lobe(s) so that they can continue to function in the usual manner. It is proven that this approach provides the same chance of cure as pneumonectomy with far lower operative complications and better quality of life.