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Thoracoscopic left S4a subsegmentectomy.

Akira Hamada1, Hiroyuki Oizumi1, Hirohisa Kato1

  • 1Second Department of Surgery, Yamagata University, Yamagata, Japan.

Journal of Thoracic Disease
|December 10, 2017
PubMed
Summary

A patient with a history of hilar cholangiocarcinoma developed a lung nodule. Surgical removal confirmed primary lung cancer, not metastasis, enabling successful treatment.

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonology

Background:

  • A 63-year-old woman with a history of hilar cholangiocarcinoma presented with a new lung nodule.
  • The nodule, measuring 8 mm in S4a, raised concerns for either metastasis or a new primary lung cancer.

Purpose of the Study:

  • To diagnose and manage a suspicious lung nodule in a patient with a prior malignancy.
  • To differentiate between metastatic disease and a primary lung cancer.

Main Methods:

  • Diagnostic workup included chest computed tomography (CT).
  • Surgical intervention involved a thoracoscopic left S4a subsegmentectomy.
  • Postoperative care included monitoring for complications and early discharge.

Main Results:

Keywords:
Thoracoscopy/video-assisted thoracic surgery (VATS)lung cancersegmentectomy/subsegmentectomy

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  • The thoracoscopic procedure was completed in 158 minutes with minimal blood loss.
  • No air leakage was observed, and the chest tube was removed on postoperative day 1.
  • The patient was discharged on postoperative day 3.
  • Final pathological diagnosis confirmed primary lung cancer (T1aN0M0 stage IA) with a 2.0 cm surgical margin.

Conclusions:

  • Thoracoscopic subsegmentectomy is a viable and effective minimally invasive approach for early-stage primary lung cancer.
  • Early diagnosis and surgical management led to a favorable outcome in this patient with a complex medical history.