Because pneumonectomy causes a high-risk of perioperative mortality and morbidity, we have tried extended sleeve lobectomy (ESL) for patients with locally advanced lung cancer. The purpose of this study is to analyze the risk of complications and local relapses of ESL. Twelve patients underwent ESL, one-lobe and segment resection for 7, bi-lobe resection for 4, and bi-lobe and segment resection for 1. There was no hospital death. Two of 12 patients (17%) had an anastomosis complication. One (8%) had a staple line relapse. We conclude that ESL is a practicable technique for locally advanced lung cancer to avoid pneumonectomy.