Results of surgical treatment of stage III lung carcinoma with carinal proximity. The role of sleeve lobectomy versus pneumonectomy and the role of sleeve pneumonectomy.

Sleeve lobectomy in specific situations can be an alternative to pneumonectomy. Sleeve pneumonectomy is an aggressive resection for carcinoma involving the tracheobronchial angle, carina, or lower trachea and lung. Sleeve lobectomy is questioned because of its technical difficulties and its postoperative complications. Sleeve pneumonectomy is controversial in that its postoperative mortality and long-term survival rates are similar, it is a technically difficult procedure, and its mortality rate is greater than that of standard pneumonectomy. The indications for the procedures and patient selection are discussed.