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A case of thoracoscopic medial basal segmentectomy
Naoya Kawakita1, Hiroaki Toba1, Shoji Sakiyama2
1Department of Thoracic and Endocrine Surgery and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
International Journal of Surgery Case Reports
|January 20, 2019
Summary
Thoracoscopic S7 segmentectomy is a feasible treatment for isolated S7 nodules, even with anatomical variations. This approach, utilizing the interlobar fissure, allows for successful resection of the medial basal segment (S7).
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Anatomy
Background:
- Isolated resection of the medial basal segment (S7) is uncommon due to its small size and anatomical variations.
- S7 segmentectomy presents surgical challenges, making alternative approaches necessary.
- Successful thoracoscopic S7 segmentectomy is reported in this case study.
Purpose of the Study:
- To report a successful case of thoracoscopic S7 segmentectomy.
- To describe the anatomical considerations for performing S7 segmentectomy.
- To establish S7 segmentectomy as a feasible treatment option for specific anatomical patterns.
Main Methods:
- A 56-year-old male patient with a suspected pulmonary metastasis of rectal cancer underwent surgery.
- A 6-mm nodule in S7 was identified and targeted for resection.
- The surgical approach involved isolating the segmental artery (A7) and bronchus (B7) via the interlobar fissure, followed by transection along the intersegmental plane indicated by V7b and selective oxygenation via B7.
Main Results:
- The anatomical relationship of A7 and B7 running ventral to the inferior pulmonary vein facilitated their isolation.
- V7a and V7b were easily isolated from the inferior pulmonary vein.
- The intersegmental plane was clearly identified, allowing for successful segmentectomy.
Conclusions:
- Thoracoscopic S7 segmentectomy is a feasible treatment option for patients with a specific anatomical pattern where A7 and B7 run ventral to the inferior pulmonary vein.
- The interlobar fissure approach is effective for isolating structures and completing the segmentectomy.
- This technique enables successful resection of the medial basal segment (S7) even with its inherent anatomical complexities.
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