Segmentectomy for treating centrally located pulmonary hamartoma: a retrospective analysis of 22 cases

This study aimed to evaluate the characteristics and outcomes of 22 pulmonary hamartoma patients with centrally localized lesions undergoing segmentectomy, and to propose a new classification system for this disease based on its location.

Consecutive pulmonary hamartoma patients who underwent segmentectomy from January 1, 2016 to June 30, 2021 were included in this retrospective study. Patients' age, sex, symptoms, lesion location in the lung parenchyma, size, type of operation, and adverse events were analyzed.

All lesions were completely removed by segmentectomy with lung parenchyma and function maximumly preserved. None of the patients experienced in-hospital mortality, severe postoperative complications, or poor recovery outcomes. No recurrence of hamartomas was observed during postoperative follow-up. Pulmonary hamartoma was classified as the peripheral, central-superficial, or central-core type based on its location, with corresponding recommended surgical approaches of wedge resection, enucleation, segmentectomy, or lobectomy, respectively.

A new, objective, and reproducible classification system based on lesion location was established. The corresponding surgical approach also reflects real-world practice. Segmentectomy is safe and effective for the treatment of the central-core type of pulmonary hamartoma, providing an alternative option for patients that previously required lobectomy.