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Completion lobectomy after radical segmentectomy for pulmonary malignancies
Mitsugu Omasa1, Hiroshi Date2, Kazuya Takamochi3
1Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan omasa@kuhp.kyoto-u.ac.jp.
Asian Cardiovascular & Thoracic Annals
|May 22, 2016
Summary
Completion lobectomy after segmentectomy is challenging but feasible. Delayed procedures (over 5 weeks) increase difficulty due to adhesions, but careful technique ensures safety.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Completion lobectomy following segmentectomy is a rare procedure.
- Limited data exists on the technical aspects and outcomes of this complex surgical approach.
Purpose of the Study:
- To systematically evaluate the details and outcomes of completion lobectomy after segmentectomy.
- To clarify the challenges and safety of this procedure in a multi-institutional setting.
Main Methods:
- Retrospective analysis of 11 patients who underwent completion lobectomy after segmentectomy between 2007 and 2013.
- Comparison of outcomes based on the interval between segmentectomy and completion lobectomy (early vs. delayed).
Main Results:
- Completion lobectomy was performed for postoperative complications, lymph node metastasis, or residual malignancy.
- Delayed completion lobectomy (≥5 weeks post-segmentectomy) was associated with increased adhesions, operative bleeding, and longer operative times.
- Pulmonary artery injury occurred only in the delayed group; however, no operation-related mortality was observed.
Conclusions:
- Completion lobectomy after segmentectomy can be performed safely.
- Surgical difficulty increases approximately 5 weeks post-segmentectomy due to adhesions, necessitating careful manipulation.
