Thoracoscopic left S1 + 2 segmentectomy as a good resolution for preserving pulmonary function.

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Oncology

Background:

• Segmentectomies are utilized for left upper lobe non-small-cell lung cancer (NSCLC).
• The impact of segmentectomies on lung volume and function remains unclear.
• Evaluating residual pulmonary function after different segmentectomy types is crucial.

Purpose of the Study:

• To compare residual pulmonary function after thoracoscopic segmentectomy versus lobectomy in the left upper lobe.
• To assess the efficacy of S1+2 segmentectomy in preserving postoperative pulmonary function.
• To determine the preservable lung volume following various segmentectomy procedures.

Main Methods:

• Patients with left upper lobe NSCLC undergoing thoracoscopic segmentectomy or lobectomy were included.
• Spirometry and 3D CT scans were performed preoperatively and 6 months postoperatively.
• Ipsilateral preserved lobe volume and forced expiratory volume in 1 second (FEV1) preservation rates were calculated and compared.

Main Results:

• S1+2 segmentectomy showed a higher postoperative FEV1 percentage (97%) compared to S1+2+3 (82%), S4+5 (86%), and left upper lobectomy (73%).
• The FEV1 preservation rate was significantly higher for S1+2 segmentectomy (83%) than for S1+2+3 segmentectomy (62%).
• Segmentectomy, particularly S1+2, demonstrated superior preservation of pulmonary function compared to lobectomy.

Conclusions:

• Thoracoscopic S1+2 segmentectomy effectively preserves postoperative pulmonary function and lung volume.
• S1+2 segmentectomy is a viable alternative to lobectomy for maintaining lung function in left upper lobe NSCLC.
• The study highlights the importance of segment selection for optimizing functional outcomes.