Atypical bronchoplasty to lung cancer and benign bronchial disease.

Twenty-one cases of atypical bronchoplasty were selected from a series of 125 tracheobronchoplastic procedures by the same surgeon between 1979 and 1993 and were reviewed to assess the indications and technical problems. The procedures were classified as follows: Type A (3 cases) was anastomosis between the right main and lower bronchi with upper and middle lobe resection. Type B (4 cases) was anastomosis between the left main and upper segmental bronchi with resection of the lower lobe and lingula or between the left main bronchus and the basal bronchus with resection of the upper lobe and superior segment of the lower lobe. Type C (5 cases) was resection of the right lateral wall of the trachea with various types of lung resection. Type D (4 cases) was sleeve segmentectomy. Type E (2 cases) was bronchial reconstruction without lung resection. Type F (3 cases) was miscellaneous procedures. All these procedures except one achieved favorable results. It is emphasized that lung-preserving surgery must always be considered under strict observation using frozen section study, even if an unusual procedure is required. If lung tissue has to be resected, as little as possible should be removed.