Outcomes of completion lobectomy long after segmentectomy

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Completion lobectomy after prior segmentectomy for lung cancer presents significant surgical challenges due to severe adhesions.
• Video-assisted thoracoscopic surgery (VATS) for these complex cases requires careful evaluation compared to traditional thoracotomy.

Purpose of the Study:

• To compare the surgical outcomes of VATS versus thoracotomy completion lobectomy performed long after initial radical segmentectomy for lung cancer.
• To assess the efficacy and safety of VATS completion lobectomy in this challenging scenario.

Main Methods:

• Retrospective evaluation of surgical outcomes for completion lobectomies performed after radical segmentectomies.
• Comparison of VATS completion lobectomy with thoracotomy completion lobectomy regarding operative time, blood loss, and complications.

Main Results:

• Five VATS and five thoracotomy completion lobectomies were performed on 10 patients.
• No significant differences were found in operative times, blood loss, or interval between surgeries between VATS and thoracotomy groups.
• Pulmonary artery injury occurred in one VATS and two thoracotomy patients; no operation-related mortality was reported.

Conclusions:

• VATS completion lobectomy is a viable option for lung cancer patients long after segmentectomy.
• The procedure can be performed safely, avoiding fatal complications, provided severe adhesions around the pulmonary artery are not present.