Predictors of successful Conservative Lung Surgery in Endobronchial Tumors

Background: Endobronchial tumors, though rare, often present centrally and may cause airway obstruction. Historically managed by pneumonectomy, conservative lung surgery has emerged as a viable alternative with reduced morbidity. Methods: This retrospective study included 69 adult patients with endobronchial tumors treated surgically at Mansoura University between 2005 and 2024. Patients were divided into two groups: Group 1 underwent pneumonectomy; Group 2 non-pneumonectomy. Clinical, radiological and bronchoscopic data were analyzed to identify predictors of successful conservative surgery. Results: Tumor location, proximity to the carina, preserved distal lung tissue, and higher preoperative FEV1% were significantly associated with conservative surgical success. Therapeutic bronchoscopy improved lung re-expansion and surgical planning. Conclusions: Conservative lung surgery is feasible and effective in selected patients with endobronchial tumors. Key predictors include anatomical accessibility, functional lung reserve, and bronchoscopic findings. A multifactorial assessment is essential for optimal surgical decision-making.