[The Novel Procedure for Thoracoscopic Anatomical Segmentectomy].

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Pulmonary Medicine

Background:

• Thoracoscopic segmentectomy is a complex surgical procedure for lung resection.
• Pre-operative planning with 3D multi-detector computed tomography (3DCT) is crucial for complex segmentectomies.
• Understanding vascular anatomy, including intersegmental and intrasegmental veins, is key for safe dissection.

Purpose of the Study:

• To describe a novel method for creating an inflation-deflation line for lung segmentectomy.
• To evaluate the safety and efficacy of thoracoscopic segmentectomy using this technique.
• To report long-term survival outcomes for patients undergoing this procedure.

Main Methods:

• Over 300 patients underwent thoracoscopic segmentectomy without mini-thoracotomy since 2004.
• Pre-operative simulation using 3D multi-detector computed tomography (3DCT) was utilized.
• A specific technique for creating an inflation-deflation line for lung segmentectomy was developed and applied.

Main Results:

• The 5-year overall survival rate was 91.8% (98.1% for curative intent).
• Cancer-specific survival rate was 100%.
• Recurrence-free survival rate was 98.1% (100% for curative intent).

Conclusions:

• The described method of thoracoscopic segmentectomy, incorporating pre-operative 3D CT and an inflation-deflation line, is technically sound.
• This approach is acceptable for selective patients undergoing lung segmentectomy.
• The technique facilitates easier parenchymal dissection and secures adequate surgical margins.