BRONCHOPLASTY IN THE MANAGEMENT OF LOW-GRADE AIRWAY NEOPLASMS AND BENIGN BRONCHIAL STENOSES

Background. Parenchyma-sparing bronchoplastic procedures have altered the management of benign bronchial stenoses and low-grade neoplasms of the airway. Reliable techniques are available to allow sleeve resecti on of any lobe or the main bronchus and thus maximize preservation of lung parenchyma. Methods. Between 1972 and 1995 we performed 100 bronc hoplastic procedures on 99 patients. Seventy-eight patients had low-gr ade or benign tumors including carcinoid, mucoepidermoid, and fibrous histiocytomas. Seven patients had inflammatory lesions including histo plasmosis and tuberculosis. Two patients had idiopathic stenosis. Thir teen patients had stenoses due to prior trauma or previous operation. Resection involved the bronchus alone in 51 cases. Sleeve lobectomies were done in 49 patients. Results. There were two postoperative deaths in complicated patients. Major complications occurred in 3 patients. Sixteen patients presented preoperatively with postobstructive pneumon ia but had no major postoperative complications. Long-term follow-up ( mean, 88 months) reveals only one instance of tumor recurrence (adenoi dcystic carcinoma) and progressive stenosis in 1 patient with idiopath ic stenosis. Conclusions. Lung-sparing bronchoplastic operations are t he procedures of choice in anatomically suited patients with low-grade malignant tumors of the airway and benign bronchial stenosis.