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Complex vs. simple segmentectomy: comparing surgical outcomes in the left upper division.

Yoichi Ohtaki1, Toshiki Yajima2,3, Toshiteru Nagashima1

  • 1Division of General Thoracic Surgery, Department of General Surgical Science, Integrative Center of General Surgery, Gunma University Hospital, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

General Thoracic and Cardiovascular Surgery
|April 19, 2022
PubMed
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This summary is machine-generated.

Complex segmentectomy for lung cancer offers improved outcomes, with less blood loss and fewer major complications compared to simpler procedures. This technique is safe and effective when performed with precise identification of intersegmental planes.

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Lung segmentectomy is a viable treatment for noninvasive or minimally invasive lung cancer.
  • Left upper division (LUD) trisegmentectomy is a common, technically simple sublobar resection for LUD tumors.
  • Outcomes comparing simple and complex segmentectomies are not well-defined.

Purpose of the Study:

  • To compare surgical outcomes and complication rates between simple LUD trisegmentectomy and other complex segmentectomies.
  • To evaluate the safety and efficacy of complex segmentectomy guided by 3D CT.

Main Methods:

  • Retrospective comparison of 118 patients undergoing simple (LUD trisegmentectomy) versus complex segmentectomy.
  • Data collected between 2010 and 2021, utilizing 3D CT for pulmonary lesion analysis.
Keywords:
Complex segmentectomyLeft upper divisionLung cancerSegmentectomySimple segmentectomy

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  • Outcomes assessed included surgical time, drainage duration, blood loss, and postoperative complications.

    • Main Results:

    • No significant difference in surgical time or drainage duration between groups.
    • Complex segmentectomy group showed significantly less blood loss (12 vs. 36 mL, p=0.023).
    • Major complications were less frequent in the complex group (3.8% vs. 13.8%, p=0.061), particularly for primary lung cancer (p=0.006).

    Conclusions:

    • Complex segmentectomy is a safe procedure when guided by 3D CT and precise intersegmental plane dissection.
    • Complex segmentectomy is not inherently a risk factor for postoperative complications.
    • Accurate identification and cutting of intersegmental planes are crucial for safe complex segmentectomy.