Does thoracoscopic basal pyramid segmentectomy really offer functional advantages in comparison with thoracoscopic...

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Oncology

Background:

• Video-assisted thoracoscopic surgery (VATS) offers minimally invasive options for lung cancer resection.
• The functional impact of basal segmentectomy versus lower lobectomy requires further clarification.

Purpose of the Study:

• To compare the functional outcomes of thoracoscopic basal segmentectomy and lower lobectomy for non-small-cell lung cancer.
• To evaluate the preservation of lung function after these VATS procedures.

Main Methods:

• Retrospective analysis of patients undergoing VATS lower lobectomy or basal segmentectomy for peripheral lung nodules (2015-2019).
• Pulmonary function tests (spirometry, plethysmography) assessed 1 month post-surgery.
• Comparison of forced expiratory volume in 1s (FEV1), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO) changes.

Main Results:

• 45 patients in the lower lobectomy group and 16 in the basal segmentectomy group completed the study.
• Both groups were homogeneous preoperatively.
• VATS basal segmentectomy showed significantly better postoperative FEV1%, FVC%, ΔFVC, and ΔFVC%, with superior FVC and DLCO recovery rates.

Conclusions:

• Thoracoscopic basal segmentectomy appears to preserve lung function more effectively than lower lobectomy.
• This VATS technique may be a suitable option for selected patients, ensuring oncological safety.
• Basal segmentectomy maintains higher FVC and DLCO levels post-surgery.