Abstract
This chapter will describe the indications for segmentectomy, a comparison of morbidity/mortality for segmentectomy and lobectomy, and discuss the issue of open versus minimally invasive operations. Segmentectomy is a true anatomic operation that should include lymphadenectomy in cancer cases. It is not a non-anatomic wedge resection.
The corresponding author of section 5.1 is Robert J. McKenna Jr., Email: robert.mckenna@providence.org (*);
The corresponding author of section 5.2 is Rodney J. Landreneau, Email: rlandren@wpahs.org (*);
The corresponding author of section 5.3 is Hiran C. Fernando, Email: hiran.fernando@bmc.org (*);
The corresponding author of section 5.4 is Brian E. Louie, Email: brian.louie@swedish.org (*);
The corresponding author of section 5.5 is Michael S. Kent, Email: mkent@bidmc.harvard.edu (*);
The corresponding author of section 5.6 is Robert J. McKenna Jr., Email: robert.mckenna@cshs.org (*);
The corresponding author of section 5.7 is Erkan Kaba, Email: erkankaba@hotmail.com (*);
The corresponding author of section 5.8 is Mark F. Berry, Email: berry037@stanford.edu (*)
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Schuchert MJ, Pettiford BL, Kilic A, et al. VATS Anatomic lung resection for non-small lung cancer (NSCL): segmentectomy versus lobectomy. Presented WTSA 2009.
Okada M, Nishio W, Sakamoto T, et al. Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg. 2005;129:87–93.
Soukiasian H, McKenna Jr RJ. Minimally invasive VATS left lobe trisegmentectomy. Ann Cardiothorac Surg. 2014;3(2):194–6.
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.
Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol. 2009;27:2553–62.
Paul S, Altorki NK, Sheng S, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg. 2010;139:366–78.
Petersen RP, Pham D, Burfeind WR, et al. Thoracoscopic lobectomy facilitates the delivery of chemotherapy after resection for lung cancer. Ann Thorac Surg. 2007;83:1245–9; discussion 1250.
Yim AP, Wan S, Lee TW, et al. VATS lobectomy reduces cytokine responses compared with conventional surgery. Ann Thorac Surg. 2000;70:243–7.
Smith CB, Mhango G, WisniveskyJP. Outcomes of elderly stage I lung cancer patients treated with segmentectomy via video assisted thoracoscopic surgery or open resection. J Clin Oncol. 2013(Suppl; abstr 7543).
Bloomer WE, Liebow AA, Hales MR. Surgical anatomy of the bronchovascular segments. Springfield: Charles C. Thomas Co; 1960.
Pettiford BL, Schuchert MJ, Santos R, Landreneau RJ. Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer. Thorac Surg Clin. 2007;17(2):175–90.
Schuchert MJ, Pettiford BL, Pennathur A, Abbas G, Awais O, Close J, Kilic A, Jack R, Landreneau JR, Landreneau JP, Wilson DO, Luketich JD, Landreneau RJ. Anatomic segmentectomy for stage I non-small-cell lung cancer: comparison of video-assisted thoracic surgery versus open approach. J Thorac Cardiovasc Surg. 2009;138(6):1318–25.
Schuchert MJ, Abbas G, Landreneau JP, Luketich JD, Landreneau RJ. Preliminary results of anatomic lung resection using energy-based tissue and vessel coagulative fusion technology. J Thorac Cardiovasc Surg. 2010;140:1168–73.
Schuchert MJ, Pettiford BL, Luketich JD, Landreneau RJ. Parenchymal-sparing resections: why, when, and how. Thorac Surg Clin. 2008;18(1):93–105.
Gossot D, Zaimi R, Fournel L, Grigoroiu M, Brian E, Neveu C. Totallythoracoscopic pulmonary anatomic segmentectomies: technical considerations. J Thorac Dis. 2013;5 Suppl 3:S200–6. doi:10.3978/j.issn.2072-1439.2013.06.25.
Fell SC. Segmental resection. Chest Surg Clin N Am. 1995;5(2):205–21.
Stair JM, Womble J, Schaefer RF, Read RC. Segmental pulmonary resection for cancer. Am J Surg. 1985;150(6):659–64.
McKenna Jr RJ. VATS lobectomy with mediastinal lymph node sampling or dissection. Chest Surg Clin N Am. 1995;5:223–32.
Luketich JD, Land SR, Sullivan EA, et al. Thoracic epidural versus intercostal nerve catheter plus patient-controlled analgesia: a randomized study. Ann Thorac Surg. 2005;79(6):1845–9.
Leshnower BG, Miller DL, Fernandez FG, et al. Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure. Ann Thorac Surg. 2010;89:1571–6.
Gossot D, Ramos R, Brian E, et al. A totally thoracoscopic approach for pulmonary anatomic segmentectomies. Int Cardiovasc Thorac Surg. 2011;12:529–33.
Swanson SJ. Segmentectomy for lung cancer. Semin Thorac Surg. 2010;22:244–9.
Peng J, Chen XL, Mao X, et al. Video-assisted thoracoscopic left upper lobe apical trisegmentectomy with the Harmonic scalpel. J Thorac Dis. 2014;6(12):1822–5.
Houck WV, Fuller CB, McKenna RJ. Video-assisted thoracic surgery upper lobe trisegmentectomy for early-stage left apical lung cancer. Ann Thorac Surg. 2004;78:1858–60.
Swanson SJ. Video-assisted thoracic surgery segmentectomy: the future of surgery for lung cancer? Ann Thorac Surg. 2010;89:S2096–7.
Gossot D, Zaimi R, Fournel L, et al. Totally thoracoscopic pulmonary anatomic segmentectomies: technical considerations. J Thorac Dis. 2013;5(S3):S200–6.
Soukiasian HJ, McKenna RJ. Minimally invasive VATS left upper lobe apical trisegmentectomy. Masters Cardiothorac Surg. 2014;3(2):194–6.
Houck WV, Fuller CB, McKenna Jr RJ. Video-assisted thoracic surgery upper lobe trisegmentectomy for early-stage left apical lung cancer. Ann Thorac Surg. 2004;78(5):1858–60.
Fan J, Chang Z, Ye C, et al. Video assisted thoracoscopic superior segmentectomy of the right lung. J Thorac Dis. 2013;5 Suppl 3:S287–8.
Halezeroglu S, Okur E, Ergene G. Single incision VATS (SIVATS) segmentectomy for lung cancer. CTS Net. 13 Apr 2015.
Schuchert MJ. Landreneau. http://az9194.vo.msecnd.net/pdfs/120401/16.05.pdf.
Tsubota N, Ayabe K, Doi O, et al. Ongoing prospective study of segmentectomy for small lung tumors. Ann Thorac Surg. 1998;66:1787–90.
Tsubota N. An improved method for distinguishing the intersegmental plane of the lung. Surg Today. 2000;30:963–4.
Yang CF, D’Amico TA. Thoracoscopic segmentectomy for lung cancer. Ann Thorac Surg. 2012;94:668–81.
Ikeda N, Yoshimura A, Hagiwara M, et al. Three dimensional computed tomography lung modeling is useful in simulation and navigation of lung cancer surgery. Ann Thorac Cardiovasc Surg. 2013;19:1–5.
Okada M, Mimura T, Ikegaki J, et al. A novel video-assisted anatomic segmentectomy technique: selective segmental inflation via bronchofiberoptic jet followed by cautery cutting. J Thorac Cardiovasc Surg. 2007;133:753–8.
Oizumi H, Kanauchi N, Kato H, et al. Total thoracoscopic pulmonary segmentectomy. Eur J Cardiothorac Surg. 2009;36:374–7.
Koike T, Yamato Y, Yoshiya K, et al. Intentional limited pulmonary resection for peripheral T1N0M0 small-sized lung cancer. J Thorac Cardiovasc Surg. 2003;125:924–8.
Yoshikawa K, Tsubota N, Kodama K, et al. Prospective study of extended segmentectomy for small lung tumors: the final report. Ann Thorac Surg. 2002;73:1055–9.
Ettinger DS, Akerley W, Borghaei H, et al. Non-small cell lung cancer, version 2.2013. JNCCN. 2013;11:645–53.
Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg. 1995;60:615–22.
Altorki NK, Yip R, Hanaoka T, et al. Sublobar resection is equivalent to lobectomy for clinical stage 1A lung cancer in solid nodules. J Thorac Cardiovasc Surg. 2014;147:754–62.
El-Sherif A, Gooding WE, Santos R, et al. Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surg. 2006;82:408–15.
Rami-Porta R, Tsuboi M. Sublobar resection for lung cancer. Eur Respir J. 2009;33:426–35.
Fan J, Wang L, Jiang GN, et al. Sublobectomy versus lobectomy for stage I non-small-cell lung cancer, a meta-analysis of published studies. Ann Surg Oncol. 2012;19:661–8.
McGuire AL, Hopman WM, Petsikas D, et al. Outcomes: wedge resection versus lobectomy for non-small cell lung cancer at the Cancer Centre of Southeastern Ontario 1998–2009. Can J Surg. 2013;56:E165–70.
Wisnivesky JP, Henschke CI, Swanson S, et al. Limited resection for the treatment of patients with stage IA lung cancer. Ann Surg. 2010;251:550–4.
Yendamuri S, Sharma R, Demmy M, et al. Temporal trends in outcomes following sublobar and lobar resections for small (≤2 cm) non-small cell lung cancers – a surveillance epidemiology end results database analysis. J Surg Res. 2013;183:27–32.
Landreneau RJ, Normolle DP, Christie NA, et al. Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage I non-small-cell lung cancer: a propensity-matched analysis. J Clin Oncol. 2014;32:2449–55.
Kates M, Swanson S, Wisnivesky JP. Survival following lobectomy and limited resection for the treatment of stage I non-small cell lung cancer<=1 cm in size: a review of SEER data. Chest. 2011;139:491–6.
Kodama K, Doi O, Higashiyama M, et al. Intentional limited resection for selected patients with T1 N0 M0 non-small-cell lung cancer: a single-institution study. J Thorac Cardiovasc Surg. 1997;114:347–53.
Koike T, Yamato Y, Yoshiya K, et al. Intentional limited pulmonary resection for peripheral T1 N0 M0 small-sized lung cancer. J Thorac Cardiovasc Surg. 2003;125:924–8.
Nakamura H, Kawasaki N, Taguchi M, et al. Survival following lobectomy vs limited resection for stage I lung cancer: a meta-analysis. Br J Cancer. 2005;92:1033–7.
Gajra A, Newman N, Gamble GP, et al. Impact of tumor size on survival in stage IA non-small cell lung cancer: a case for subdividing stage IA disease. Lung Cancer. 2003;42:51–7.
Koike T, Terashima M, Takizawa T, et al. Clinical analysis of small-sized peripheral lung cancer. J Thorac Cardiovasc Surg. 1998;115:1015–20.
Okada M, Nishio W, Sakamoto T, et al. Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg. 2005;129:87–93.
Port JL, Kent MS, Korst RJ, et al. Tumor size predicts survival within stage IA non-small cell lung cancer. Chest. 2003;124:1828–33.
Wisnivesky JP, Yankelevitz D, Henschke CI. The effect of tumor size on curability of stage I non-small cell lung cancers. Chest. 2004;126:761–5.
Blasberg JD, Pass HI, Donington JS. Sublobar resection: a movement from the Lung Cancer Study Group. J Thorac Oncol. 2010;5:1583–93.
Asamura H. Role of limited sublobar resection for early-stage lung cancer: steady progress. J Clin Oncol. 2014;32:2403–4.
Wolf AS, Richards WG, Jaklitsch MT, et al. Lobectomy versus sublobar resection for small (2 cm or less) non-small cell lung cancers. Ann Thorac Surg. 2011;92:1819–23.
Suzuki K, Nagai K, Yoshida J, et al. Predictors of lymph node and intrapulmonary metastasis in clinical stage IA non-small cell lung carcinoma. Ann Thorac Surg. 2001;72:352–6.
Kent M, Landreneau R, Mandrekar S, et al. Segmentectomy versus wedge resection for non-small cell lung cancer in high-risk operable patients. Ann Thorac Surg. 2013;96:1747–54.
Keenan RJ, Landreneau RJ, Maley RH, et al. Segmental resection spares pulmonary function in patients with stage I lung cancer. Ann Thorac Surg. 2004;78:228–33.
Harada H, Okada M, Sakamoto T, et al. Functional advantage after radical segmentectomy versus lobectomy for lung cancer. Ann Thorac Surg. 2005;80:2041–5.
Macke RA, Schuchert MJ, Odell DD, et al. Parenchymal preserving anatomic resections result in less pulmonary function loss in patients with Stage I non-small cell lung cancer. J Cardiothorac Surg. 2015;10:49.
Mery CM, Pappas AN, Bueno R, et al. Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest. 2005;128:237–45.
Berry MF. Role of segmentectomy for pulmonary metastases. Ann Cardiothorac Surg. 2014;3:176–82.
Schuchert MJ, Abbas G, Awais O, et al. Anatomic segmentectomy for the solitary pulmonary nodule and early-stage lung cancer. Ann Thorac Surg. 2012;93:1780–5.
Atkins BZ, Harpole Jr DH, Mangum JH, et al. Pulmonary segmentectomy by thoracotomy or thoracoscopy: reduced hospital length of stay with a minimally-invasive approach. Ann Thorac Surg. 2007;84:1107–12.
Villamizar NR, Darrabie MD, Burfeind WR, et al. Thoracoscopic lobectomy is associated with lower morbidity compared with thoracotomy. J Thorac Cardiovasc Surg. 2009;138:419–25.
Paul S, Altorki NK, Sheng S, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy: a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg. 2010;139:366–78.
Berry MF, D’Amico TA, Onaitis MW, et al. Thoracoscopic approach to lobectomy for lung cancer does not compromise oncologic efficacy. Ann Thorac Surg. 2014;98:197–202.
Flores RM, Ihekwrazu UN, Risk N, et al. Patterns of recurrence and incidence of second primary tumors after lobectomy by means of video-assisted thoracoscopic surgery (VATS) versus thoracotomy for lung cancer. J Thorac Cardiovasc Surg. 2011;141:59–64.
Whitson BA, Groth SS, Duval SJ, et al. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg. 2008;86:2008–16.
Leshnower BG, Miller DL, Fernandez FG, et al. Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure. Ann Thorac Surg. 2010;89:1571–6.
Author information
Authors and Affiliations
Corresponding authors
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
McKenna, R.J. et al. (2017). Segmentectomy. In: Wang, J., K. Ferguson, M. (eds) Atlas of Minimally Invasive Surgery for Lung and Esophageal Cancer. Springer, Dordrecht. https://doi.org/10.1007/978-94-024-0835-5_5
Download citation
DOI: https://doi.org/10.1007/978-94-024-0835-5_5
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-024-0833-1
Online ISBN: 978-94-024-0835-5
eBook Packages: MedicineMedicine (R0)