Chengwu Liu1, Hu Liao1, Chenglin Guo1, Qiang Pu1, Jiandong Mei1, Lunxu Liu2. 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China. 2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China; Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China. Electronic address: lunxu_liu@aliyun.com.
Abstract
OBJECTIVE: Thoracoscopic anatomic single or combined basal segmentectomy is technically challenging because of the variation and deep location of vessels and bronchi in the parenchyma. This study aimed to describe thoracoscopic segmentectomy of basal segments using a single-direction method. METHODS: This retrospective study included 137 patients who underwent single or combined thoracoscopic basal segmentectomy between April 2015 and August 2019. All procedures were performed via the preferred inferior pulmonary ligament approach or an interlobar fissure approach following a single-direction strategy. RESULTS: Ninety patients underwent single basal segmentectomy, and 47 patients underwent combined basal segmentectomy. Median operative time was 125 minutes (range, 52-237 minutes), and median blood loss was 30 mL (range, 5-250 mL). Median chest tube duration was 2 days (range, 1-22 days), and median postoperative hospital stay was 4 days (range, 2-24 days). The postoperative morbidity rate was 5.1% (7/137). No perioperative deaths were identified. Pathological examination revealed 133 cases of lung cancer, 2 cases of metastasis, and 2 cases of benign tumors. No recurrence or mortality was observed during the median follow-up period of 15 months (range, 1-53 months). CONCLUSIONS: The single-direction method for thoracoscopic single or combined basal segmentectomy was feasible and safe in our experience. This method exposes the targeted vessels and bronchi from superficial to deep in order of their appearance and enables anatomic resection of a single segment or combined basal segments to be performed in a simple manner while avoiding dissection of a hypoplastic fissure or inessential splitting of the lung parenchyma.
OBJECTIVE: Thoracoscopic anatomic single or combined basal segmentectomy is technically challenging because of the variation and deep location of vessels and bronchi in the parenchyma. This study aimed to describe thoracoscopic segmentectomy of basal segments using a single-direction method. METHODS: This retrospective study included 137 patients who underwent single or combined thoracoscopic basal segmentectomy between April 2015 and August 2019. All procedures were performed via the preferred inferior pulmonary ligament approach or an interlobar fissure approach following a single-direction strategy. RESULTS: Ninety patients underwent single basal segmentectomy, and 47 patients underwent combined basal segmentectomy. Median operative time was 125 minutes (range, 52-237 minutes), and median blood loss was 30 mL (range, 5-250 mL). Median chest tube duration was 2 days (range, 1-22 days), and median postoperative hospital stay was 4 days (range, 2-24 days). The postoperative morbidity rate was 5.1% (7/137). No perioperative deaths were identified. Pathological examination revealed 133 cases of lung cancer, 2 cases of metastasis, and 2 cases of benign tumors. No recurrence or mortality was observed during the median follow-up period of 15 months (range, 1-53 months). CONCLUSIONS: The single-direction method for thoracoscopic single or combined basal segmentectomy was feasible and safe in our experience. This method exposes the targeted vessels and bronchi from superficial to deep in order of their appearance and enables anatomic resection of a single segment or combined basal segments to be performed in a simple manner while avoiding dissection of a hypoplastic fissure or inessential splitting of the lung parenchyma.