Thirty-day outcomes after lobectomy or segmentectomy for lung cancer surgery

Although lobectomy has been the standard operation for clinical T1aN0M0 non-small cell lung cancer, recent studies have shown that segmentectomy could be a substitute for lobectomy. However, the differences between lobectomy and segmentectomy in terms of perioperative complications have not been fully evaluated.

Between February 2006 and February 2013, 100 patients underwent lobectomy and 111 underwent segmentectomy for clinical T1aN0M0 non-small-cell lung cancer. We performed a retrospective comparison of perioperative morbidity, age, sex, pulmonary function, and Charlson comorbidity index in the 2 groups. Data were analyzed for all patients and for their propensity score-matched pairs.

The incidence of postoperative complications in the segmentectomy group (n = 21, 19%) was significantly higher than that in the lobectomy group (n = 7, 7%; p < 0.01). The average operative time of 263 ± 64 min and estimated blood loss of 133 ± 125 mL for segmentectomy were significantly greater than those for lobectomy (201 ± 61 min and 88 ± 101 mL). In propensity score-matched analysis, the mean operative time of 270 ± 70 min for segmentectomy was longer than that for lobectomy (202 ± 67 min). Postoperative complications were more frequent in the segmentectomy group than in the lobectomy group (19.6% vs. 6.5%, p = 0.03).

Although segmentectomy offers preservation of pulmonary function, significantly more postoperative complications occurred in the segmentectomy group. Surgeons should bear in mind that complications can happen more frequently after segmentectomy than after lobectomy for T1aN0M0 non-small-cell lung cancer.