Introduction: airway surgery—pushing the limits
Sleeve resections of the tracheobronchial tree are performed to avoid pneumonectomy and to achieve a complete resection in centrally located lung tumors. In 1947, Sir Clement Price Thomas performed the first right upper lobe sleeve lobectomy for adenoma (1). He also reported about a case series of 36 sleeve lobectomies including a sleeve resection of the left main bronchus with upper lobe and sleeve of pulmonary artery in 1959 (2). Allison performed the first sleeve lobectomy for lung cancer in 1952 (3). In 1957, Barclay et al. reported the first resection of the bifurcation (4). Two years later, Gibbon performed the first sleeve pneumonectomy (5). Formerly, sleeve resections were performed only by the worldwide leaders in the field of thoracic surgery.
It was not a surgery for everybody by that time!
Nowadays, sleeve lobectomy has become a routine procedure at least in open thoracic surgery. Sleeve lobectomy has been established in residency and fellowship programs even if it is still a very demanding surgical procedure.
Stagnation is regression!
Especially, video-assisted and robotic-assisted tracheobronchial surgeries are very demanding and complex surgeries nowadays. These surgeries are performed by a minority in our specialty.
In my personal view, it is not a surgery for everybody today!
However, it may become a routine procedure in the future. We have to push the limits. As demanded by Hippocrates 400 B.C., we have to share our expertise and knowledge with others. Leaders in the field of tracheobronchial surgery are sharing their tremendous expertise with us in various review articles. I hope you will enjoy the present special issue with various very valuable contributions on that topic of airway surgery.
Acknowledgments
Funding: None.
Footnote
Provenance and Peer review: This article was commissioned by the editorial office, Journal of Thoracic Disease for the series “Airway Surgery”. This article did not undergo external peer review.
Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.03.06). The series “Airway Surgery” was commissioned by the editorial office without any funding or sponsorship. SB served as the unpaid Guest Editor for the series and serves as the unpaid editorial board of Journal of Thoracic Disease from Nov 2018 to Oct 2020.
Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
References
- Thomas CP. Conservative resection of the bronchial tree. J R Coll Surg Edinb 1956;1:169-86. [PubMed]
- Thomas CP. Conservative and extensive resection for carcinoma of the lung. Ann R Coll Surg Engl 1959;24:345-65. [PubMed]
- Jones PH. Lobectomy and bronchial anastomosis in the surgery of bronchial carcinoma. Ann R Coll Surg Engl 1959;25:20-38. [PubMed]
- Barclay RS, McSwan N, Welsh TM. Tracheal reconstruction without the use of grafts. Thorax 1957;12:177-80. [Crossref] [PubMed]
- Chamberlain JM, McNeill TM, Parnassa P, et al. Bronchogenic carcinoma: an aggressive surgical attitude. J Thorac Cardiovasc Surg 1959;38:727-45. [Crossref] [PubMed]
