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Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
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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
PubMed
Summary

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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:

Keywords:
Lung neoplasmsNeoplasmsPneumonectomyPostoperative complicationsReoperationTissue adhesionssecond primary

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  • 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.