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Bilateral segmentectomies using virtual-assisted lung mapping (VAL-MAP) for metastatic lung tumors.

Keita Nakao1, Masaaki Sato2, Jun-Ichi Nitadori1

  • 1Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Surgical Case Reports
|September 19, 2017
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Summary

Virtual-assisted lung mapping (VAL-MAP) enabled successful bilateral segmentectomies for impalpable lung metastases. This minimally invasive approach preserved pulmonary function, demonstrating VAL-MAP

Keywords:
Metastatic pulmonary tumorThoracoscopic surgeryVirtual-assisted lung mapping (VAL-MAP)

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Virtual-assisted lung mapping (VAL-MAP) is utilized for locating impalpable lung nodules during resections.
  • Segmentectomy and wedge resection are common procedures for lung nodules.
  • Metastatic lung nodules require precise surgical localization and removal.

Purpose of the Study:

  • To report a case of bilateral segmentectomy using VAL-MAP for synchronous lung metastases.
  • To evaluate the chronological changes in pulmonary function after the procedure.
  • To demonstrate the efficacy of VAL-MAP in complex bilateral lung resections.

Main Methods:

  • A 50-year-old female patient with colorectal cancer and bilateral lung metastases underwent staged thoracoscopic segmentectomies.
  • Virtual-assisted lung mapping (VAL-MAP) guided the resection of impalpable nodules in both lungs.
  • Pulmonary function tests were monitored postoperatively to assess functional impact.

Main Results:

  • Bilateral segmentectomies were successfully performed using VAL-MAP for small, impalpable metastatic lung tumors.
  • Adequate surgical margins were achieved in all resected nodules.
  • Postoperative pulmonary function, including forced vital capacity (FVC) and forced expiratory volume (FEV) 1.0, showed minimal decrease compared to predictions.

Conclusions:

  • VAL-MAP is an effective tool for guiding bilateral segmentectomies in cases of impalpable lung metastases.
  • The technique facilitates precise resection while minimizing pulmonary function loss.
  • This case highlights the successful application of VAL-MAP in managing metastatic lung disease.