Merve Ekinci FIDAN, Volkan ERDOĞU, Melike ÜLKER, Ali Cevat KUTLUK, Ezgi KILIÇASLAN, Meral Selin Onay MAHMUTI, Nisa YILDIZ, Ayşegül ÇİFTÇİ, Muzaffer METİN
Current Thoracic Surgery - 2026;11(1):72-81
Background: In selected patients, lung-sparing airway resections may achieve complete oncological resection while preserving pulmonary parenchyma. With increasing experience in video-assisted thoracoscopic surgery (V ATS), these complex procedures can now be performed using minimally invasive techniques. We aimed to present our single-center experience with V ATS lung-sparing tracheobronchial and carinal resections, focusing on perioperative outcomes. Materials and Methods: Data from 7 patients who underwent V ATS lung-sparing airway resections in our clinic between February 2022 and December 2024 were retrospectively evaluated in terms of surgical indications, as well as preoperative, intraoperative, and postoperative conditions. Results: The surgical procedures included isolated carinal resection and reconstruction in two patients, main bronchial bronchotomy with bronchoplastic resection and reconstruction in two patients, segmental sleeve resection of the right main bronchus in one patient, and segmental sleeve resection of the bronchus intermedius in two patients, including one posterior biportal and one anterior uniportal approach. The mean age was 46.4 +/- 17.1 years (range: 26-67). Pathological diagnoses included four typical carcinoid tumors, one glomus tumor, one sarcoma, and one squamous cell carcinoma. All resections achieved negative surgical margins. Postoperatively, the mean time to chest drain removal was 1.86 +/- 0.38 days, and the mean length of hospital stay was 4.43 +/- 1.40 days. No intraoperative mortality occurred, and no major postoperative complications or anastomotic failures were observed. Conclusions: V ATS lung-sparing tracheobronchial and carinal resections are feasible and safe in carefully selected patients. These procedures allow complete oncological resection while preserving lung parenchyma, with favorable perioperative outcomes and short hospital stays. Minimally invasive lung-sparing airway surgery may offers a valuable alternative to more extensive resections in selected tracheobronchial tumors.
