[Dawn of Radical Segmentectomy for Small Sized Peripheral Non-small Cell Lung Cancer]

The result of prospective, randomized, controlled, trial, Japan Clinical Oncology Group (JCOG) 0802/ West Japan Oncology Group( WJOG) 4607L, has been published in April 2022. The superiority in overall survival for patients who underwent segmentectomy for small sized peripheral non-small cell lung cancer( NSCLC)( whole tumor size≤2 cm, C/T ratio>0.5) compared with those undergoing lobectomy has been demonstrated for the first time in the world. Segmentectomy might become a standard surgical procedure for such tumors. Consequently, the opportunity to perform segmentectomy will increase. Developing techniques for segmentectomy is an urgent issue for general thoracic surgeons because segmentectomy generally requires more advanced surgical technique than lobectomy. In particular, the radical segmentectomy is an anatomically limited resection with hilar and mediastinal lymph node dissection. That means anatomically accurate resection of the pulmonary segment. There are a lot of points to be mastered in operative indications based on tumor size, phenotype, and location, understandings of anatomy, surgical techniques, transition to lobectomy, and so on. In this article, we would like to share some tips on segmentectomy primarily focusing on the surgical techniques.