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Updated: Apr 23, 2026
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Published on: August 15, 2025
Wedge resection for localized infectious lesions: high margin/lesion ratio guaranteed operational safety
Yifeng Sun1, Likun Hou1, Huikang Xie1
11 Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China ; 2 Department of Thoracic Surgery, Shanghai Chest Hospital Affiliated Shanghai Jiaotong University, Shanghai 200030, China ; 3 Department of Pathology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
Objective:
This study aims to elucidate the risk factors of pulmonary complications for localized infectious lesions with limited resection.
Methods:
We retrospectively investigated 139 cases for which wedge resection had been performed for localized pulmonary infectious lesions. Patients included 85 males and 54 females with a median age of 53 years (range: 21-74 years old). Forty-six patients had focal organizing pneumonia (OP), sixty patients had lung abscess, twenty-three patients had aspergilloma, five patients had lung abscess combining aspergillus fumigatus, and five patients had lung abscess combined with tuberculosis granuloma. Information regarding perioperative manipulations, surgical complications, and follow-ups were collected for further analysis.
Results:
Prominent pneumonia developed in eight cases post-operation. In follow-up, one patient had a recurrence of lung abscess five months post-operation and underwent a left upper lobectomy and one patient died two months after discharge because of respiratory failure that resulted from pneumonia. Univariate and multivariate analysis showed a significant difference in the margin/lesion ratio (distance between staple margins to lesion/the maximum tumor diameter) between patients with pulmonary complications and those without complications (P=0.01). The best cut-off value of margin/lesion ratio to complication was 0.985, and a margin/lesion ratio less than 0.985 was associated with high post-operative complications.
Conclusions:
The present case series shows that partial resection for localized pulmonary infection is an acceptable surgical manipulation. A high margin/lesion ratio achievement may guarantee operational safety.
