What Is Tracheo-Bronchial Sleeve Resection?

Tracheobronchial sleeve resection is a surgery performed to save a part and function of the lungs, typically for non-small-cell lung cancer.

Tracheobronchial sleeve resection or a sleeve lobectomy is a surgical procedure to remove a lobe of the lungs and part of the bronchi (airway) usually to eliminate a cancerous or aggressive tumor. 

In this procedure, the ends of the bronchus are rejoined, and any remaining lobes are reattached to the bronchus. This surgery is performed to save a part and function of the lungs. This procedure is usually done for non-small-cell lung cancer.

Lung cancers are broadly divided into two types depending on the affected cells and size of the cancer:

• Small-cell lung cancer (SCLC): This type is aggressive cancer and comprises about 20% of lung cancers. SCLC metastasizes rapidly into many sites within the body and are most often discovered after they have spread extensively. 
• Non-small-cell lung cancer (NSCLC): These are the most common lung cancers, accounting for about 80% of all lung cancers.

Tracheobronchial sleeve resection is recommended when an individual has a central lung tumor that has moved to the airway but has not invaded the lymph nodes or other parts of the lungs.

A tracheobronchial sleeve resection procedure is a major surgery and usually performed under general anesthesia. The procedure is usually completed within 120 minutes. On rare occasions, additional time would be required to complete the procedure. 

• The surgeon monitors the patient’s vitals during the procedure once the anesthesia kicks in.
• The surgeon usually cleans the chest area with an antiseptic solution and marks the area for an incision.
• Once the incision is made, the surgeon reaches to the diseased area of the lungs. 
• During the procedure, the surgeon will remove a lobe of the lungs in addition to part of the airway that sends air to the lobe. 
• The surgeon will then reconnect the airway to the remaining lobe after removing the affected part. 
• The goal of a sleeve lobectomy is to remove the cancerous tissue and preserve the function of the lungs.
• Once the cancerous lobe is removed and airway lobes are connected, bleeding is stopped, and the surgeon sutures the incisions. The patient may have few tubes on the chest to drain the blood and secretions. The tube is usually removed after a few days. 

Tracheo-bronchial sleeve resection is a complicated and risky procedure due to the following complications:

• Severe bleeding
• Respiratory failure
• Shortness of breath
• Pulmonary embolism (air in the lungs)
• Heart attack
• Sudden death
• Need for a total lung removal
• Pneumonia (infection in the lungs)
• Shock
• Abnormal heart rhythms
• Reduced blood flow to the heart

Tracheobronchial sleeve resection has a quick recovery period compared with other major surgeries. Patients are usually discharged after 10 days of the procedure. Most of the patients recover within 45-60 days after the discharge. The doctor may recommend a nutrition diet with breathing exercises. The patient may also be on painkillers and antibiotics for a few days. Usually, patients can get back to their normal life after 60 days.

Tracheobronchial sleeve resection is less risky than other surgeries of lung cancers. Patients typically experience fewer complications and have an improved quality of life because they can breathe better. 

Moreover, the death rate is lower than that in other lung cancer procedures. This procedure is usually considered to save lung function and increase the life expectancy of patients.