Zhang Xianfei, Li Chengqiang, Jin Runsen, Li Hecheng
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Surg. 2022 Jul 8;9:948878. doi: 10.3389/fsurg.2022.948878. eCollection 2022.
Segmentectomy has played a crucial role in the treatment of early-stage lung cancer after the publication of JCOG0802, which indicated that patients with small-sized peripheral non-small-cell lung cancer could receive better survival from segmentectomy than lobectomy despite a higher local recurrence. The intraoperative identification of the intersegmental plane ensures complete resection of the lesion with sufficient margin so that it is deemed as the critical part of segmentectomy. Diverse methods have been developed to acquire distinguishable and lasting borderline between segments, but none of them is proved perfect. In this review, we searched and classified these techniques that emerged from the beginning when segmentectomy was used for bronchiectasis until now. Comparisons between different ways in mechanisms, facility, and safety were made to depict a comprehensive landscape for surgeons to select fit one. Furthermore, we presented our vision for the future of intersegmental plane identification.
在JCOG0802发表后，肺段切除术在早期肺癌治疗中发挥了关键作用。该研究表明，对于小尺寸外周型非小细胞肺癌患者，尽管肺段切除术局部复发率较高，但与肺叶切除术相比，其生存效果更佳。术中识别肺段间平面可确保病变的完整切除并获得足够切缘，因此被视为肺段切除术的关键部分。人们已开发出多种方法来获取各肺段之间可区分且持久的边界，但尚无一种方法被证明是完美的。在本综述中，我们对自肺段切除术用于支气管扩张症以来直至目前出现的这些技术进行了检索和分类。对不同方法在机制、便利性和安全性方面进行了比较，以便为外科医生描绘出一幅全面的图景，使其能够选择合适的方法。此外，我们还阐述了对肺段间平面识别未来发展的展望。
