Department of Surgery, Suita Municipal Hospital, Suita, Japan.
Multimed Man Cardiothorac Surg. 2024 May 3;2024. doi: 10.1510/mmcts.2023.102.
Segmentectomies involving the posterior basal segment (S10) of the lower lobe present a challenging surgical procedure due to anatomical complexities, especially when lesions extend towards the lateral basal segment (S9). We introduce a combined subsegmentectomy technique via a posterior approach for a lesion situated between S9b and S10b, which preserves subsegmental branches that do not affect the resection margin of the tumour and facilitates intersegmental division without extending dissection into the interlobar region. This technique, the goal of which is to reduce the extent of dissection and complex stapling, is expected to minimize pulmonary complications and intrathoracic adhesions without compromising oncological outcomes. By potentially mitigating challenges in an ipsilateral reoperation, this approach offers a valuable alternative for managing second lung cancers.
段切除术涉及下叶的后基底段(S10),由于解剖结构复杂,特别是当病变延伸至基底外侧段(S9)时,手术具有挑战性。我们介绍了一种通过后入路进行的联合亚段切除术技术,用于治疗位于 S9b 和 S10b 之间的病变,该技术保留了不会影响肿瘤切除边界的亚段分支,并有助于进行节段间分离,而无需将解剖延伸至叶间区域。该技术的目的是减少解剖和复杂吻合的范围,预计可以减少肺并发症和胸腔内粘连,而不会影响肿瘤学结果。通过减轻同侧再次手术的挑战,这种方法为治疗第二肺癌提供了一种有价值的选择。