Pediatric and Adult Telescopic Bronchial Sleeve Resections: Our 15 Years of Experience with Robot-Assisted, Video-Assisted and Open Surgery.

The bronchial sleeve represents a pivotal advancement in thoracic surgery, allowing for oncological radicality while preserving respiratory function. We present 29 cases of telescopic monofilament continuous suture bronchial sleeves out of a total of 43 bronchial sleeve resections performed by us. There were no mortalities, no bronchial positive margins, no local recurrences, and only one anastomotic fistula requiring pneumonectomy with open window thoracostomy, which closed after a few months (Fig. 2). The telescopic intussusception technique avoids the significant problem of caliber discrepancy, and this type of suture consolidates with the physiological increases in airway pressure due to Valsalva maneuver or coughing, because the internal "endobronchial" pressure generated is applied radially on the smaller caliber bronchus, pushing it and causing it to adhere to the larger caliber external bronchus.