The advantage of sleeve lobectomy over pneumonectomy

The comment from Dr. Ludwig (1) to ore recent paper on lower sleeve lobectomy, the so-called “Y” sleeve (2), is interesting and it deals on some important points related to technical aspects in this setting. It is a pleasure to reply to an author that has published important contributions on sleeve lobectomy, reporting, over time, results from patients that had undergone sleeve lobectomy and pneumonectomy. Our experience is in line with other experiences like that of Dr. Ludwig and colleague (3). We strongly believe in the dramatic importance represented by offering, when technically and mainly oncologically feasible, bronchovascular reconstructive procedures in order to avoid pneumonectomy for the resection of centrally located lung cancer. In her letter, Dr. Ludwig recalls the advantage of sleeve lobectomy over pneumonectomy in term of postoperative mortality and morbidity as showed by the published series (3-7)