Role of anatomical sublobar resection in lung cancer and how to do it efficiently?
Lau Hui Ping
Professor & Senior consultant,
Dept. of Cardiothoracic Surgery,
Chang Gung Memorial Hospital,
Chang Gung University, Taiwan
Anatomical sublobar resection (segmentectomy) is a complicated procedure and segmental lung resection requires the oncology standard of the separation of pulmonary segment veins, arteries, bronchi, and the removal of the segmental lung parenchymal tissue. As segmentectomy can maximize the preservation of normal lung function, it has now become a popular procedure in selected lung cancer patients. The procedure has recently been increasingly performed with the help of accurate anatomical sketch using 3-D computed tomography and the identification of the intersegmental plane. A 3D model from these images is created according to the surgeon’s needs. With the vascular pattern in mind the surgeon can perform a safer dissection of the pulmonary artery branches, especially when the fissure is fused and/or when lymph nodes are present.
Segmentectomy is a complex surgical procedure with a high technical demand, and thus, surgeons need to go through meticulous training to perform the procedure. Preoperative 3-D modeling can help making decision and plan the adequate thoracoscopic anatomical sublobar resections.