Thoracoscopic complex basilar segmentectomies: an analysis of 63 procedures.

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Thoracoscopic complex basilar segmentectomies present significant technical challenges.
• Evaluating surgical outcomes and potential complications is crucial for complex lung resections.

Purpose of the Study:

• To assess if the complexity of thoracoscopic basilar segmentectomies leads to specific surgical issues.
• To determine if these complex procedures result in increased post-operative morbidity.

Main Methods:

• Retrospective analysis of 63 patients undergoing intention-to-treat thoracoscopic complex basilar segmentectomy (excluding S6) between 2007-2019.
• Data collected included indications, preoperative assessment, clinical features, operative details, and early post-operative outcomes.
• Complex basilar segmentectomies involved resection of segments from the basilar pyramid, excluding S6.

Main Results:

• Sixty-three patients (median age 66) underwent segmentectomies, primarily S9+10 and S8.
• 71% of planned operations were completed; 27% required extended resection, and 6% converted to open surgery.
• Complications occurred in 17% of patients, with no mortality. Median hospital stay was 4 days.

Conclusions:

• Complex basilar segmentectomies have a higher extension rate than other sublobar resections.
• Despite increased extension rates, post-operative morbidity for complex basilar segmentectomies is comparable to other sublobar resections.