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Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure.
Ann Thorac Surg. 2010 May; 89(5):1571-6.AT

Abstract

BACKGROUND

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.

METHODS

We performed a retrospective review of patients who underwent a segmentectomy between May 2002 and March 2009 at Emory University Hospital.

RESULTS

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.

CONCLUSIONS

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.

Authors+Show Affiliations

Division of Cardiothoracic Surgery, Joseph B Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20417779

Citation

Leshnower, Bradley G., et al. "Video-assisted Thoracoscopic Surgery Segmentectomy: a Safe and Effective Procedure." The Annals of Thoracic Surgery, vol. 89, no. 5, 2010, pp. 1571-6.
Leshnower BG, Miller DL, Fernandez FG, et al. Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure. Ann Thorac Surg. 2010;89(5):1571-6.
Leshnower, B. G., Miller, D. L., Fernandez, F. G., Pickens, A., & Force, S. D. (2010). Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure. The Annals of Thoracic Surgery, 89(5), 1571-6. https://doi.org/10.1016/j.athoracsur.2010.01.061
Leshnower BG, et al. Video-assisted Thoracoscopic Surgery Segmentectomy: a Safe and Effective Procedure. Ann Thorac Surg. 2010;89(5):1571-6. PubMed PMID: 20417779.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure. AU - Leshnower,Bradley G, AU - Miller,Daniel L, AU - Fernandez,Felix G, AU - Pickens,Allan, AU - Force,Seth D, PY - 2009/11/11/received PY - 2010/01/19/revised PY - 2010/01/21/accepted PY - 2010/4/27/entrez PY - 2010/4/27/pubmed PY - 2010/6/4/medline SP - 1571 EP - 6 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 89 IS - 5 N2 - BACKGROUND: 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. METHODS: We performed a retrospective review of patients who underwent a segmentectomy between May 2002 and March 2009 at Emory University Hospital. RESULTS: 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. CONCLUSIONS: 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. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/20417779/Video_assisted_thoracoscopic_surgery_segmentectomy:_a_safe_and_effective_procedure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(10)00220-1 DB - PRIME DP - Unbound Medicine ER -