Nakazawa Seshiru, Shimizu Kimihiro, Kawatani Natsuko, Obayashi Kai, Ohtaki Yoichi, Kosaka Takayuki, Yajima Toshiki, Shirabe Ken
Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
J Thorac Dis. 2022 Jan;14(1):113-122. doi: 10.21037/jtd-21-1545.
Segmentectomy is now a common treatment option for both lung cancer and metastatic lung tumors with increasing data and evidence. However, data on multiple segmentectomy of different lobes are scarce. Our objective was to clarify the clinicopathological features of multiple segmentectomy.
We reviewed patients who underwent segmentectomy between January 2010 and December 2019 at Gunma University Hospital. Multiple segmentectomy was defined as segmentectomy of different lobes during the same operation, in contrast to single segmentectomy, which was defined as segmentectomy of a single lobe. Clinicopathologic, operative, and postoperative results were compared between multiple segmentectomy and single segmentectomy.
There were 324 patients who underwent single segmentectomy and 11 patients (12 cases) who underwent multiple segmentectomy. Multiple segmentectomy was mostly performed for treatment of metastatic lesions rather than lung cancer. The median number of resected segments was 1 (range, 1-5) in the single segmentectomy group and 3 (range, 2-4) in the multiple segmentectomy group. The median number of resected lung lesions was 3.5 in the multiple segmentectomy group. Multiple segmentectomy was associated with longer operative time, more bleeding, and longer drainage period and postoperative stay than the single segmentectomy group. There were no significant differences in severe complications as well as 30- and 90-day mortality.
Multiple segmentectomy is a lung-preserving procedure that can be considered for patients with multiple lung lesions and has feasible postoperative outcomes.
随着数据和证据的增加，肺段切除术目前是肺癌和肺转移瘤的常见治疗选择。然而，关于不同肺叶多段切除术的数据很少。我们的目的是阐明多段切除术的临床病理特征。
我们回顾了2010年1月至2019年12月在群马大学医院接受肺段切除术的患者。多段切除术定义为在同一手术中对不同肺叶进行的肺段切除术，与之相对的是单段切除术，其定义为对单个肺叶进行的肺段切除术。比较多段切除术和单段切除术的临床病理、手术及术后结果。
有324例患者接受了单段切除术，11例患者（12例手术）接受了多段切除术。多段切除术主要用于治疗转移性病变而非肺癌。单段切除术组切除段数的中位数为1（范围1 - 5），多段切除术组为3（范围2 - 4）。多段切除术组切除肺病灶数的中位数为3.5。与单段切除术组相比，多段切除术的手术时间更长、出血量更多、引流时间和术后住院时间更长。严重并发症以及30天和90天死亡率方面无显著差异。
多段切除术是一种保肺手术，对于有多个肺部病灶的患者可以考虑采用，且术后结果可行。
