A sleeve resection is an anatomical pulmonary resection (segmentectomy, lobectomy or pneumonectomy) combined with the excision of a bronchial segment, with the anastomosis between the airway proximal and distal to it. This technique allows a certain number of centrally located tumors to be completely resected with sufficient margins of healthy tissue. Thus it is possible that the rest of the involved lung can be spared (sleeve segmentectomy or lobectomy), or a pneumonectomy can be performed despite invasion of the carina or distal trachea. The comparison of series of sleeve and conventional resections shows similar 5-year survival rates if the stage and histological subtypes are taken into account. The specific morbidity of the procedure is the partial or complete breakdown of the anastomosis (producing a stenosis or a bronchopleural fistula). This is uncommon and can usually be prevented by the use of a protective perianastomotic flap.