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Thoracoscopic segmentectomy for trans-fissure ground-glass opacity.

Min Zhang1, Anming Wu2, Cheng Zhang1

  • 1Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Interdisciplinary Cardiovascular and Thoracic Surgery
|May 9, 2024
PubMed
Summary

Anatomical segmentectomy is a safe and effective surgical option for treating trans-fissure ground-glass opacities (GGOs), offering shorter hospital stays compared to traditional methods.

Keywords:
Ground-glass opacityMarginSegmentectomyTrans-fissure

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Area of Science:

  • Thoracic Surgery
  • Pulmonology
  • Surgical Oncology

Background:

  • Trans-fissure ground-glass opacities (GGOs) are unique lesions exceeding 2 cm, located on fused fissures and involving two adjacent lobes.
  • Surgical resection of trans-fissure GGOs using segmentectomy has not been previously reported.

Purpose of the Study:

  • To evaluate the safety and efficacy of anatomical segmentectomy for treating trans-fissure GGOs.
  • To compare outcomes of segmentectomy with traditional surgical methods for these lesions.

Main Methods:

  • A retrospective study included 84 patients with trans-fissure GGOs (lesion size >2 cm, consolidation tumour ratio <50%) operated between August 2016 and December 2022.
  • Preoperative 3D CT bronchography and angiography were utilized for surgical planning.
  • Patients were divided into a traditional group (lobectomy + wedge, n=36) and a new method group (anatomical segmentectomy + function-preserving sublobectomy, n=48).

Main Results:

  • The new method group showed a significantly shorter median hospital stay (2 days vs. 4 days).
  • Postoperative complications were comparable, with 1 case of air leakage and 5 cases of haemoptysis in the traditional group versus 2 cases of air leakage in the new method group.
  • The median margin was larger in the new method group (3.3 cm vs. 2.5 cm).

Conclusions:

  • Anatomical segmentectomy is a safe and effective approach for resecting trans-fissure GGOs.
  • This technique, when combined with meticulous preoperative planning, allows for safe en bloc resection.
  • Segmentectomy offers potential benefits such as reduced hospital stay compared to traditional methods.