"Separated" precise subsegmentectomy: Single-port thoracoscopic noncombined subsegmentectomy in one lung lobe

Area of Science:

• Thoracic surgery
• Pulmonary medicine
• Surgical oncology

Background:

• Combined segmental resection (CSS) can preserve lung function but may be insufficient for multiple GGO nodules.
• Conventional CSS or wedge resection cannot always remove all nodules, often leading to lobectomy.
• A novel technique, "separated" precise subsegmentectomy, aims to preserve more lung tissue in such cases.

Purpose of the Study:

• To assess the feasibility and safety of "separated" precise subsegmentectomy for specific GGO nodules.
• To evaluate the efficacy of this technique in preserving lung function.

Main Methods:

• "Separated" precise subsegmentectomy was performed on selected patients with specific GGO nodules.
• Data collected included clinical information, operative details (time, bleeding), length of stay, CT findings, and lung function.
• Lung function and CT changes were analyzed post-operatively.

Main Results:

• The procedure was successfully completed in 12 patients.
• Median operative time was 96 minutes, with 50 ml blood loss and a 4-day hospital stay.
• One case each of pulmonary infection and persistent air leakage occurred; no major complications or deaths were reported. Lung function retention was 91.7% at 3 months, with good lung inflation on CT.

Conclusions:

• "Separated" precise subsegmentectomy is a novel, safe, and effective surgical method.
• It offers an optimized approach for preserving lung function in patients with multiple GGO nodules.
• Further large-scale prospective studies are warranted to validate these findings.