Short- and Long-Term Outcomes of Sleeve Lobectomy Versus Pneumonectomy.
1Fizza Iftikhar Ahmed, Dr. Aman Ullah 2 , Dr Muhammad Parvez 3 , Dr Farhat Bano 4 ,Ghulam Shabbir Pervez 5 , Muhammad Kamran Khan 6 ,
Submission: 15 January 2026 | Acceptance: 29 January 2026 | Publication: 11 February 2026,
1. Consultant Thoracic Surgeon Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi.
2. FCPS general surgery Pakistan Petroleum Limited Sui Field hospital, Sui Balochistan.
3. Professor of Surgery Wah Medical College/POF Hospital,Wah cant.
4. Associate professor surgery SMBBMC Lyari
5. Rashid Latif Medical and Dental College Feroz pur Road Lahore.
6. Assistant professor of Surgery Dawadmi college of medicine, Shaqra University, KSA.
Abstract :
Introduction: Pneumonectomy or sleeve lobectomy are the two surgical options available for treating centrally located non-small cell lung cancer (NSCLC). A sleeve lobectomy involves removing the entire lung, while a pneumonectomy preserves the lung parenchyma through bronchoplastic reconstruction. To maximize patient survival, functional recovery, and quality of life, it is crucial to comprehend the relative short- and long-term results of these operations.
Goal: In patients with centrally located NSCLC, compare the short-term perioperative outcomes, long-term survival, and functional outcomes of sleeve lobectomy versus pneumonectomy.
Methods: A retrospective cohort study was carried out on 120 patients who had elective thoracic surgery for non-small cell lung cancer (NSCLC); 60 of these patients had sleeve lobectomies,and the remaining 60 had pneumonectomy. ICU stay, hospital length of stay, postoperative pulmonary complications, and 30- and 90-day mortality were among the short-term outcomes.Recurrence rates, pulmonary function, disease-free survival, and 5-year overall survival were among the long-term outcomes. SPSS was used for statistical analysis, and to account for confounding variables, Cox regression and Kaplan-Meier survival analysis were used.
Results: Compared to pneumonectomy, sleeve lobectomy was linked to significantly lower 30-day (3.3% vs 13.3%, p = 0.04) and 90-day mortality (5% vs 16.7%, p = 0.03), fewer postoperative pulmonary complications (13.3% vs 45%, p < 0.01), and shorter hospital (7.2 ± 2.1 vs 11.5 ± 3.4 days, p = 0.001) and intensive care unit stays (1.8 ± 0.7 vs 3.4 ± 1.2 days, p =0.001). Sleeve lobectomy was associated with improved postoperative pulmonary function(FEV1: 2.1 ± 0.3 vs. 1.6 ± 0.4 L, p = 0.001), better disease-free survival (83.3% vs. 63.3%, p =0.02), and higher 5-year overall survival (91.7% vs. 70%, p = 0.01). Between groups, recurrence rates were similar.
Conclusion: For centrally located NSCLC, sleeve lobectomy provides better short- and long term results than pneumonectomy. Long-term survival is increased, pulmonary function is maintained, and perioperative morbidity and mortality are decreased. When it is technically possible, sleeve lobectomy should be the preferred surgical procedure, especially in facilities with skilled thoracic surgeons.
Keywords: Pneumonectomy, sleeve lobectomy, non-small cell lung cancer, survival, postoperative results, and pulmonary function.