Miura Kentaro, Eguchi Takashi, Hamanaka Kazutoshi, Sonehara Kei, Komatsu Masamichi, Shimizu Kimihiro
Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Gen Thorac Cardiovasc Surg. 2025 Feb;73(2):118-122. doi: 10.1007/s11748-024-02087-x. Epub 2024 Oct 12.
Pulmonary segmentectomy for small non-palpable tumors, such as lung cancer or pulmonary metastasis, is challenging owing to possible insufficient surgical margins. Particularly, extensive segmentectomy beyond the second lobe may be required to obtain a sufficient surgical margin for a tumor adjacent to an incomplete interlobar fissure. Radiofrequency identification (RFID) marking systems have proven beneficial for detecting small lung tumors during surgery. Herein, we present two representative cases of complex segmentectomy (left-side video-assisted thoracoscopic extended S + S segmentectomy and left-side robot-assisted thoracoscopic extended S b + c segmentectomy) for small lung cancer adjacent to an incomplete interlobar fissure. Extensive segmentectomy was avoided, and preservation of lung parenchyma was feasible using an RFID system. The patients could undergo segmentectomy safely with a sufficient surgical margin. In conclusion, an RFID system facilitates secure and safe precise segmentectomy while minimizing the resected pulmonary volume.
对于难以触及的小肿瘤，如肺癌或肺转移瘤，肺段切除术因手术切缘可能不足而具有挑战性。特别是，对于靠近不完全叶间裂的肿瘤，可能需要进行超过第二叶的广泛段切除术以获得足够的手术切缘。射频识别（RFID）标记系统已被证明有助于在手术期间检测小肺肿瘤。在此，我们展示了两例针对靠近不完全叶间裂的小肺癌进行复杂段切除术（左侧电视辅助胸腔镜扩大S+S段切除术和左侧机器人辅助胸腔镜扩大S b+c段切除术）的代表性病例。使用RFID系统避免了广泛的段切除术，并且可行肺实质的保留。患者能够在具有足够手术切缘的情况下安全地进行段切除术。总之，RFID系统有助于安全、精确地进行段切除术，同时将切除的肺体积降至最低。
