ABSTRACT
The most common indication for left-sided pulmonary resection is lung cancer. Surgery may also be indicated for the management of less common malignancies affecting the lung or for benign diseases such as bronchiectasis. For most patients with early stage lung cancer, lobectomy is the procedure of choice. If the tumor cannot be completely resected by lobectomy, pneumonectomy must be considered if the patient's pulmonary reserve allows it. Left-sided sleeve resections are done infrequently not only because no bronchus intermedius exists on that side but also because left pneumonectomy is better tolerated than right pneumonectomy. The evaluation of pulmonary function should be complemented by spirometric studies and analysis of arterial blood gases. One of the most common complications of lobectomies is a persistent air leak (>5 days) with or without residual space. In general, operation on the left lung can be done quite safely if the operating surgeon follows a systematic, carefully thought-out approach for the mobilization of bronchovascular pedicles.
