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Superior Lingular S⁴ Segmentectomy.

Seshiru Nakazawa¹, Toshiki Yajima², Kazuki Numajiri¹

¹Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan.

The Annals of Thoracic Surgery

|May 4, 2021

Summary

Atypical segmentectomies are less common due to limited data. This study details the method for left S4 segmentectomy, a lung-preserving option for specific lung tumor cases.

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Area of Science:

Thoracic surgery
Surgical anatomy
Pulmonology

Background:

Segmentectomy is a standard lung cancer surgery, but atypical resections are less frequent.
Lack of detailed anatomical and surgical data hinders the performance of atypical segmentectomies.
The left superior lingular S4 segment is often resected with other segments due to its perceived small size.

Observation:

The size of the S4 segment varies significantly among individuals.
Tumors located at the junction of the upper division and lingular segments are candidates for S4 segmentectomy.
This procedure can be a lung-sparing alternative when performed on carefully selected patients.

Findings:

This paper outlines the anatomical and surgical prerequisites for performing a left S4 segmentectomy.
The methodology is derived from the authors' practical experience and a review of existing literature.
Successful S4 segmentectomy requires precise knowledge of segmental anatomy and surgical landmarks.

Implications:

Standardizing atypical segmentectomy techniques can improve lung cancer treatment options.
Accurate anatomical knowledge facilitates lung-preserving surgeries, enhancing patient outcomes.
This work provides a foundation for further research and training in specialized segmentectomies.