Resections in benign and malign lung diseases have to be carried out sparing parenchyma maximally, in order to preserve the patient’s respiratory functional reserves as much as possible. In malignancies, complete surgical remission, however, must be guaranteed in the first place. Remarkedly, local recurrence of bronchial carcinoma occurs in 19% of cases after segmental resections, both anatomic and atypical, versus 4% after lobectomy in stage I, the 30-day lethality being 1% versus 5%. Where pneumonectomy can be avoided, bronchial sleeve resections are typically required. They are classically indicated on tumor involvement of the origin of the upper lobe bronchus, both with and without lymph node metastasis (stages II–IIIA at the right, I–II at the left). In 30% of the cases, bronchial sleeve resections are performed in combination with segmental resection of the associated pulmonary artery. There is a wide variety of standardized techniques both at the bronchi and the vessels. 5-Year survival rates after sleeve resections are 52% in stage I, 42% in stage II, 18% in stage IIIA, which corresponds with the survival rates after standard surgery. 30-day lethality is 7.6% after all sleeve procedures. The typical early complications resulting from bronchial insufficiency occur in 9.4% of cases, which might be reduced by the use of modern absorbable monofilament. Vascular complications, on the other hand, are very rare. Cicatricial stenoses occur as late complications. In the surgery of pulmonary metastases from various primaries, atypical segmental or wedge resections are the procedures used most frequently (69%). For parenchyma-sparing resections of metastatic lesions, too, sleeve resections both at the bronchial and the vascular tree are carried out, with the same techniques, variations and early/late complications as in bronchial carcinoma. The frequently used median approach is not adequate for bronchoplasty procedures on the left