Sleeve lobectomy or pneumonectomy for non-small cell lung cancer? Searching for an optimal balance between oncological, surgical and functional results

The main objective in surgery for non-small cell lung cancer (NSCLC) is to achieve good oncologic safety, which includes R0 resection of the tumor and radical lymphadenectomy. Patients with centrally-located NSCLC should undergo pneumonectomy (PN) but, considering the not negligible morbidity and mortality related to this technique, they could benefit from a lung tissue-preserving resection, especially when cardio-pulmonary reserve is limited. Since Thomas (1) firstly applied this procedure for therapeutic option, “sleeve” pulmonary resection was designed to conserve as much pulmonary tissue as possible.