• Atsushi Watanabe, Syunsuke Ohori, Shinji Nakashima, Tohru Mawatari, Norio Inoue, Yoshihikoi Kurimoto, and Tetsuya Higami.
• Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. atsushiw@sapmed.ac.jp
• Eur J Cardiothorac Surg. 2009 May 1; 35 (5): 775-80; discussion 780.

ObjectiveSegmentectomy for non-small cell lung cancer (NSCLC) is believed to increase the rates of recurrence and postoperative air leak. We sought to present our clinical data and outcome of VATS (video-assisted thoracoscopic surgery) segmentectomies with systematic node dissection for selected NSCLC patients.MethodsInclusion criteria were clinical T1N0M0 peripheral NSCLC measuring ResultsThe mean operative time and intraoperative bleeding were 220 min (range 100-306) and 183 ml (30-730), respectively. The number of stapler cartridges used for intersegmental division was 2 (1-5). Postoperative air leak (>7 days), which required no surgical intervention, occurred in two patients. The chest tube drainage duration was 3 days. There were no in-hospital deaths. The numbers of resected subsegments and reserved subsegments in comparison with lobectomy were 5 (2-13) and 5 (3-13), respectively. The FEV1.0 after VS was higher than the predictive FEV1.0 after lobectomy, if the latter was performed as standard procedure. We experienced four cases of distant metastasis after segmentectomy, but there was no case of local recurrence. The 5-year survival and recurrence-free survival rates in pathological stage IA NSCLC were 89.9% and 93.3%, respectively.ConclusionsVATS segmentectomy with systematic node dissection is a reasonable treatment option for selected peripheral NSCLC.

27 keywords...

hide…