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Article ; Online: Uniportal video-assisted thoracoscopic left superior segmentectomy.

Andolfi, Marco / Guiducci, Gian / Xiumè, Francesco / Salati, Michele / Roncon, Alberto / Refai, Majed

Multimedia manual of cardiothoracic surgery : MMCTS

2020 Volume 2020

Abstract: ... superior segmentectomy of the left lower lobe, adopting two different techniques for identifying ... Therefore, during thoracoscopic segmentectomy, where the direct palpation of the tumor is not always possible, it is ... segmentectomy. Although a one-size-fits-all method is not feasible, we strongly recommend making every effort ...

Abstract	Obtaining adequate margins when performing lung cancer resection is crucially important. Therefore, during thoracoscopic segmentectomy, where the direct palpation of the tumor is not always possible, it is mandatory to accurately identify the intersegmental plane in order to achieve a satisfactory oncological and surgical result. In this video tutorial, we demonstrate a uniportal video-assisted thoracoscopic (VATS) superior segmentectomy of the left lower lobe, adopting two different techniques for identifying the intersegmental plane: the inflation-deflation method and selective resected segmental inflation, and we present the pros and cons of each. With the inflation/deflation technique, which is the most common maneuver used, we inflated the whole lung after occlusion of the target segmental bronchus, inducing collapse of the superior segment and inflation of the remaining lobe. However, this inexpensive and easy method often makes identification of the intersegmental plane unreliable because of the collateral ventilation. Moreover, because of the expansion of inflated segments, it limits thoracic working space during the VATS procedure. In contrast, selective resected segmental inflation guarantees an optimal surgical space even during a VATS procedure. In this case, we directly inflated the segmental bronchus of the superior segment through a butterfly needle in order to selectively expand only the selected segment. The careful demarcation of the intersegmental plane is mandatory in order to obtain adequate margins and achieve a high success rate for thoracoscopic segmentectomy. Although a one-size-fits-all method is not feasible, we strongly recommend making every effort for identifying it as best as possible; indeed, its inadequate demarcation may be the main cause of unsatisfactory surgical and oncological results in terms of locoregional recurrence and long-term survival.
MeSH term(s)	Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery ; Aged ; Colorectal Neoplasms/pathology ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/secondary ; Lung Neoplasms/surgery ; Male ; Pneumonectomy/methods ; Thoracic Surgery, Video-Assisted/methods
Language	English
Publishing date	2020-05-11
Publishing country	England
Document type	Case Reports ; Video-Audio Media
ZDB-ID	2280156-X
ISSN	1813-9175 ; 1813-9175
ISSN (online)	1813-9175
ISSN	1813-9175
DOI	10.1510/mmcts.2020.014
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Thoracoscopic superior segmentectomy, left lower lobe.

Rakovich, George

Multimedia manual of cardiothoracic surgery : MMCTS

2019 Volume 2019

Abstract: ... Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic ... Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases ...

Abstract	Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that allows direct access to the segmental structures, is straightforward, and is versatile enough to allow adaptation in case of unexpected intraoperative findings (such as conversion to lobectomy in the case of positive margins). Key aspects of the procedure include proper patient positioning, appropriate positioning of operating trocars, standardized technique to expose and dissect of the segmental vein, bronchus, and artery, and accurate division of the intersegmental plane and fissure.
MeSH term(s)	Adenocarcinoma/surgery ; Aged ; Bronchi/surgery ; Humans ; Lung Neoplasms/surgery ; Male ; Pneumonectomy/methods ; Thoracoscopy/methods
Language	English
Publishing date	2019-07-09
Publishing country	England
Document type	Case Reports ; Video-Audio Media
ZDB-ID	2280156-X
ISSN	1813-9175 ; 1813-9175
ISSN (online)	1813-9175
ISSN	1813-9175
DOI	10.1510/mmcts.2019.021
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Article ; Online: Completely thoracoscopic superior segmentectomy of the right lower lobe.

Rakovich, George

Multimedia manual of cardiothoracic surgery : MMCTS

2018 Volume 2018

Abstract	Minimally invasive pulmonary segmentectomy allows adequate oncologic treatment in selected cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. Although several variations of minimally invasive pulmonary segmentectomy have been described, I favor a fully thoracoscopic multiport approach that allows direct access to the segmental structures, and is straightforward and versatile enough to allow adaptation (such as conversion to lobectomy in the case of positive margins) if there are unexpected intraoperative findings. Key aspects of the procedure include proper patient positioning, appropriate positioning of operating trocars, standardized technique to expose and dissect the segmental vein, bronchus, and artery, and accurate division of the intersegmental plane and fissure.
MeSH term(s)	Adenocarcinoma/diagnosis ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery ; Aged ; Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/secondary ; Lung Neoplasms/surgery ; Male ; Pneumonectomy/methods ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Thoracoscopy/methods
Language	English
Publishing date	2018-11-19
Publishing country	England
Document type	Case Reports ; Video-Audio Media
ZDB-ID	2280156-X
ISSN	1813-9175 ; 1813-9175
ISSN (online)	1813-9175
ISSN	1813-9175
DOI	10.1510/mmcts.2018.027
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Article: Thoracoscopic superior segmentectomy.

Moremen, Jacob R / Tong, Betty C / Ceppa, Duykhanh P

Annals of cardiothoracic surgery

2014 Volume 3, Issue 2, Page(s) 202–203

Language	English
Publishing date	2014-04-18
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2713627-9
ISSN	2304-1021 ; 2225-319X
ISSN (online)	2304-1021
ISSN	2225-319X
DOI	10.3978/j.issn.2225-319X.2014.02.02
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Article: Video-assisted thoracoscopic superior segmentectomy of the right lower lobe.

Pan, Xue / Zhang, Yan / Ren, Shuang / Ding, Zheng / Li, Xiangnan / Zhu, Dengyan / Zhang, Chunyang / Zhao, Jia

Journal of thoracic disease

2016 Volume 8, Issue 6, Page(s) 1349–1352

Abstract: ... the adequate pretreatment with a targeted antimicrobial, thoracoscopic resection of superior segment ... of the right lower pulmonary lobe was finally performed in the order of the superior segmental artery ... the superior segmental vein, the superior segmental bronchus, and the pulmonary tissues of the superior segment ...

Abstract	A 61-year-old male patient was referred to the thoracic surgery department due to repeated hemoptysis for more than one year. The computed tomography revealed a 5.2 cm × 3.1 cm mass in the right lower lobe and the nature of the mass was confirmed to be chronic inflammation by trans percutaneous lung biopsy. Bronchiectasis of the right lower lobe was considered based on the symptoms, signs, and imaging findings. Surgery for bronchiectasis is used only as part of a multimodality treatment approach. After the adequate pretreatment with a targeted antimicrobial, thoracoscopic resection of superior segment of the right lower pulmonary lobe was finally performed in the order of the superior segmental artery, the superior segmental vein, the superior segmental bronchus, and the pulmonary tissues of the superior segment. Total surgery time was 70 min and blood loss was 100 mL. The chest tube was removed on the 3(th) postoperative day. The patient was discharged home on the 8(th) postoperative day.
Language	English
Publishing date	2016-05-16
Publishing country	China
Document type	Journal Article
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2016.04.33
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Article: Video-assisted thoracoscopic superior segmentectomy of the right lower lobe.

Fan, Junqiang / Chang, Zhibo / Ye, Chenyang / Zhao, Baiqin / Shen, Gang / Chai, Ying

Journal of thoracic disease

2013 Volume 5 Suppl 3, Page(s) S287–8

Abstract: ... function on pre-operation evaluation underwent thoracoscopic superior segementectomy with systemic ...

Abstract	Sublobar resections are still controversial for lung cancer, but for patients who can't tolerate lobectomy, such as those suffering from cardiopulmonary comorbidities and aged people, sublobar resections are better choices. Lobectomy and sublobar resections have similar surgical effect on patients with tumors ≤2 cm. A 64-year-old patient with chronic obstructive pulmonary disease (COPD) and poor pulmonary function on pre-operation evaluation underwent thoracoscopic superior segementectomy with systemic mediastinal lymph node dissection. Three holes were adopted, the major operation hole was a 3 cm mini-incision in the 4(th) intercostal space of anterior axillary line. The patient has recovered well after the surgery.
Language	English
Publishing date	2013-09-10
Publishing country	China
Document type	Case Reports
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.3978/j.issn.2072-1439.2013.07.18
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Article: Single incision thoracoscopic left lower lobe superior segmentectomy for non-small cell lung cancer.

Jeon, Hyun Woo / Choi, Soo Hwan / Wang, Young Pil / Hyun, Kwan Yong

The Korean journal of thoracic and cardiovascular surgery

2014 Volume 47, Issue 2, Page(s) 185–188

Abstract: ... of an 86-year-old female with NSCLC treated by single-incision segmentectomy. ... for non-small cell lung cancer (NSCLC). Nowadays, video-assisted thoracoscopic surgery (VATS) is gaining acceptance ... instrumentation advances, single-incision thoracoscopic surgery has emerged over time. Here, we report the case ...

Abstract	Lobectomy with mediastinal node dissection has been standard treatment for non-small cell lung cancer (NSCLC). Nowadays, video-assisted thoracoscopic surgery (VATS) is gaining acceptance as an alternative treatment option, given the quality-of-life benefits that it confers. For the VATS procedure, most surgeons create two or three ports with a utility incision of 3 to 5 cm. However, with acquired skill and instrumentation advances, single-incision thoracoscopic surgery has emerged over time. Here, we report the case of an 86-year-old female with NSCLC treated by single-incision segmentectomy.
Keywords	covid19
Language	English
Publishing date	2014-04-10
Publishing country	Korea (South)
Document type	Case Reports
ISSN	2233-601X
ISSN	2233-601X
DOI	10.5090/kjtcs.2014.47.2.185
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Article: What is the benefit of preserving the superior segment in anatomical thoracoscopic resections of the lower lobe?

Yoon, Seung Keun / Yun, Jae Kwang / Choi, Sehoon / Kim, Hyeong Ryul / Kim, Yong-Hee / Kim, Dong Kwan / Park, Seung-Il / Lee, Geun Dong

Journal of thoracic disease

2023 Volume 15, Issue 11, Page(s) 6009–6018

Abstract: ... segmentectomy remains unknown. We aimed to evaluate the effect of preserved superior segment on lung volume and ... between 2004 and 2020, 48 patients who received thoracoscopic common basal segmentectomy were included and ... differences between common basal segmentectomy (segmentectomy group) and lower lobectomy (lobectomy group) (4 ...

Abstract	Background: The beneficial effect of preserved superior segment (S6) after common basal segmentectomy remains unknown. We aimed to evaluate the effect of preserved superior segment on lung volume and function. Methods: Among 671 segmentectomies and 2,249 lobectomies for clinical stage IA lung cancer between 2004 and 2020, 48 patients who received thoracoscopic common basal segmentectomy were included and compared with 96 patients who received thoracoscopic lower lobectomy after propensity score matching. The variables analyzed were age, sex, comorbidity, smoking history, preoperative forced expiratory volume in one second (FEV1), clinical T stage, histology, and tumor location. Lung volume was assessed using a three-dimensional (3D) computed tomography (CT)-based volumetric method. Results: There were no significant differences between common basal segmentectomy (segmentectomy group) and lower lobectomy (lobectomy group) (4,183.8±1,114.9 versus 3,850.7±1,132.1 mL; P=0.10) in terms of preoperative CT-measured total lung volume. At the immediate postoperative median follow-up period (6.4 months), the reduced percentage of CT-measured total lung volume in the segmentectomy group was significantly larger than that in the lobectomy group (-16.2% versus -6.5%; P=0.004). The percentage of CT-measured contralateral lung volume expansion in the segmentectomy group was significantly smaller than that in the lobectomy group (-0.7% versus +8.9%; P=0.006). At the last median follow-up period (43.1 months), the reduced percentage of CT-measured total lung volume in the segmentectomy group remained larger than that in the lobectomy group (-13.0% versus -3.0%; P=0.01). The reduced percentage of postoperative FEV1 in the segmentectomy group did not differ from that in the lobectomy group (-9.9% versus -11.5%, P=0.63). Conclusions: Preserving the superior segment might not provide beneficial effect on the preservation of postoperative lung volume and function after common basal segmentectomy compared with lower lobectomy.
Language	English
Publishing date	2023-11-08
Publishing country	China
Document type	Journal Article
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd-23-791
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Article: Comparison of different approaches in complete thoracoscopic segmentectomy of lung lower lobe.

Mitsuboshi, Shota / Matsumoto, Takako / Omata, Motoka / Shidei, Hiroaki / Ogihara, Akira / Aoshima, Hiroe / Isaka, Tamami / Nishiuchi, Masaki / Kanzaki, Masato

Journal of thoracic disease

2023 Volume 15, Issue 6, Page(s) 2958–2970

Abstract: ... underwent a complete lung lower lobe thoracoscopic segmentectomy, excluding S6 and basal segments (from S7 ... thoracoscopic segmentectomy of the lower lobe, excluding S6 and basal segments, using the PL approach is ... Background: Safe and oncologically acceptable segmentectomy outcomes were reported for early-stage ...

Abstract	Background: Safe and oncologically acceptable segmentectomy outcomes were reported for early-stage lung cancer. The high-resolution computed tomography allowed us to find detailed structures inside the lungs, such as the pulmonary ligaments (PLs). Hence, we have presented the relatively anatomically challenging thoracoscopic segmentectomy, for the resection of the lateral basal segment, the posterior basal segment, and both segments through the PL as a PL approach. This study aimed to retrospectively examine the lung lower lobe segmentectomy, excluding the superior and basal segments (from S7 to S10), using the PL approach as an option to treat the lower lobe tumors of the lung. We then compared the efficacy of the PL approach in terms of safety with the interlobar fissure (IF) approach. The characteristics of the patients, intra- and postoperative complications, and surgical outcomes were analyzed. Methods: Of the 510 patients who underwent segmentectomy for malignant lung tumors from February 2009 to December 2020, 85 were included in this study. Among them, 41 underwent a complete lung lower lobe thoracoscopic segmentectomy, excluding S6 and basal segments (from S7 to S10), using the PL approach, and the remaining 44 used the IF approach. Results: The median age in 41 patients in the PL group was 64.0 years (range, 22-82), and that in 44 patients in the IF group was 66.5 years (range, 44-88), with significant differences in gender between these groups. Video-assisted thoracoscopic surgery and robot-assisted thoracoscopic surgery were performed on 37 and 4 patients in the PL group and 43 and 1 patient in the IF group, respectively. Postoperative complication frequency was not significantly different between these groups. The most common complications were the air leaks that persisted for over 7 days in 1 and 5 patients in the PL and IF groups, respectively. Conclusions: Complete thoracoscopic segmentectomy of the lower lobe, excluding S6 and basal segments, using the PL approach is a reasonable option for lung lower lobe tumors compared with the IF approach.
Language	English
Publishing date	2023-04-24
Publishing country	China
Document type	Journal Article
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd-22-1535
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Article: Application of uniportal video-assisted thoracoscopic surgery for segmentectomy in early-stage non-small cell lung cancer: A narrative review.

Wang, Linlin / Cao, Jiandong / Feng, Yong / Jia, Renxiang / Ren, Yi

Heliyon

2024 Volume 10, Issue 9, Page(s) e30735

Abstract: Uniportal video-assisted thoracoscopic surgery (UVATS) segmentectomy has emerged as an effective ... outcomes. Particularly advantageous in preserving lung function, UVATS segmentectomy is a compelling option ... considerations, challenges, and prospects of UVATS segmentectomy. Furthermore, it aimed to update advancements ...

Abstract	Uniportal video-assisted thoracoscopic surgery (UVATS) segmentectomy has emerged as an effective approach for managing early-stage non-small-cell lung cancer (NSCLC). Compared to conventional open and thoracoscopic surgeries, this minimally invasive surgical technique offers multiple benefits, including reduced postoperative discomfort, shorter hospital stays, expedited recovery, fewer complications, and superior cosmetic outcomes. Particularly advantageous in preserving lung function, UVATS segmentectomy is a compelling option for patients with compromised lung capabilities or limited pulmonary reserve. Notably, it demonstrates promising oncological results in early-stage NSCLC, with long-term survival rates comparable to those of lobectomies. Skilled thoracic surgeons can ensure a safe and effective execution of UVATS despite the potential technical challenges posed by complex tumor locations that may hinder visibility and maneuverability within the thoracic cavity. This study provided a comprehensive review of the literature and existing studies on UVATS segmentectomies. It delves into the evolution of the technique, its current applications, and the balance between its benefits and limitations. This discussion extends the technical considerations, challenges, and prospects of UVATS segmentectomy. Furthermore, it aimed to update advancements in segmentectomy for treating early-stage NSCLC, offering in-depth insights to thoracic surgeons to inform more scientifically grounded and patient-specific surgical decisions.
Language	English
Publishing date	2024-05-03
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e30735
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