CPT® Code 32442

Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)

The CPT® Code 32442 refers to a surgical procedure known as a sleeve pneumonectomy, which involves the removal of a lung along with a segment of the trachea, followed by a surgical connection between the remaining trachea and the main bronchus. This complex procedure is typically performed through a posterolateral thoracic incision, which is made in the intercostal space, starting just below the shoulder blade and extending around to the front of the chest. In some cases, to enhance access to the surgical site, a rib may be removed. The procedure begins with the deflation of the lung, followed by the ligation and division of major blood vessels supplying the lung. The main bronchus is then clamped and incised to facilitate the removal of the lung. In addition to the lung, a section of the trachea is excised, along with the diseased or damaged lung tissue. After the lung is removed, the remaining bronchus is surgically attached to the remaining segment of the trachea, ensuring that the airway remains patent. This procedure is critical in cases where lung disease necessitates the removal of both lung and tracheal segments, allowing for the preservation of respiratory function while addressing the underlying pathology.