A comparison of wedge and segmental resection of the lung

In the past few years there has been increasing use of limited resection for pulmonary carcinoma, especially in patients with restricted cardiorespiratory function. Because there is frequently a choice as to the type of limited resection, it was considered worth while to review the safety and efficiency of the two principal types. In total, 212 wedge resections and 281 segmental resections are reported. Despite certain theoretical advantages to segmentectomy, wedge resection carried a lower complication rate. Seventy-one per cent of wedge resections were free of complications compared to 54% of segmental resections. Minor complications were defined as apical air space and apical haematoma. The incidence of minor complications was similar for each group, 22% for wedge resections and 27% for segmentectomies. However, there was a significantly higher major complication rate in the segmental resection group (19%) compared to the wedge group (7%). This is understandable, considering the amount of raw lung surface exposed after segmental resection. It appears that where it is surgically feasible, wedge resection should be practised.