Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure.

Anatomic sublobar resection is currently being assessed as an alternative to lobectomy for primary lung cancers less than 2 cm in size. Open segmentectomy is a proven oncologic procedure for patients with reduced cardiopulmonary reserve and significant comorbidities. With the increased use of thoracoscopy, a video-assisted thoracoscopic surgery (VATS) segmentectomy may be as safe and effective as an open segmentectomy. We performed a retrospective review of patients who underwent a segmentectomy between May 2002 and March 2009 at Emory University Hospital. Forty-one patients underwent pulmonary segmentectomy; 26 through thoracotomy (open) and 15 by a thoracoscopic (VATS) approach. Both groups were well matched for age, gender, and preoperative risk factors. Segmentectomy was performed for primary lung cancer in 25 (61%) patients. There was no difference in tumor size, number of lymph node stations sampled, or number of lymph nodes removed based upon approach. The remaining indications for surgery were metastatic disease in 12 patients and benign disease in 4 patients. All patients underwent R0 resections. There was no significant difference in operative time, but patients undergoing a VATS segmentectomy had significantly reduced chest tube durations and hospital stays. Major complications occurred in 19% of patients in the open group and none in the VATS group. There were two operative deaths (4.8%), both in the open group. Video-assisted thoracoscopic surgery segmentectomy is a safe procedure which has fewer complications and a reduced hospital stay when compared with an open segmentectomy. This approach may be the ideal oncologic procedure for patients with small lung cancers (<2 cm) and (or) limited cardiopulmonary reserve and significant comorbidities.

Leshnower BG ，Miller DL ，Fernandez FG ，Pickens A ，Force SD ... -  《-》

Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach.

Atkins BZ ，Harpole DH Jr ，Mangum JH ，Toloza EM ，D'Amico TA ，Burfeind WR Jr ... -  《-》

The safe transition from open to thoracoscopic lobectomy: a 5-year experience.

Seder CW ，Hanna K ，Lucia V ，Boura J ，Kim SW ，Welsh RJ ，Chmielewski GW ... -  《-》

Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer.

Shapiro M ，Weiser TS ，Wisnivesky JP ，Chin C ，Arustamyan M ，Swanson SJ ... -  《-》

Video-assisted thoracic surgery sleeve lobectomy: a case series.

Mahtabifard A ，Fuller CB ，McKenna RJ Jr 《-》