Correlation of residual lung complications with radiological findings after pulmonary segmentectomy

To investigate the clinical characteristics of residual lung complications following segmentectomy.

Among 901 patients who underwent segmentectomy for lung cancer between 2009 and 2022, 256 patients who underwent postoperative computed tomography (CT) for abnormal shadows on chest radiography were retrospectively evaluated and categorized into three groups: Type 1 (consolidation only adjacent to the intersegmental line), Type 2 (partial infiltration extended to the residual segment [< 50%]), and Type 3 (infiltration extended to the large area of the residual segment [≥ 50%]). The association between the CT findings and complications was also assessed.

There were no significant differences in the background factors among the three types. However, Type 3 patients experienced more severe pulmonary-related complications than Types 1 and 2 (45.8% vs. 25.0%, P = 0.002). Most patients (n = 894, 99.2%) were discharged without surgical intervention, but seven (0.78%) required reoperation for complications. Of these, six had Type 3 CT findings, and five underwent left upper division segmentectomy.

Extensive postoperative infiltrative shadows in the residual segment are associated with severe complications after segmentectomy. In cases in which the shadow occupies more than half of the remaining segment, special attention to postoperative management is necessary to prevent lethal complications.