RT Book, Section
A1 Rice, David C.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170410298
T1 Minimally Invasive Segmentectomy for Malignancy
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170410298
RD 2024/10/10
AB Sublobar  resection  refers  to  any  pulmonary  resection  in  which  only  part  of  the  pulmonary  lobe  is  removed.  Nonanatomic  sublobar  resection  is  commonly  called  wedge  resection  (see  Chapter  79).  It  implies  removal  of  the  target  lesion  and  associated  surrounding  lung  parenchyma  without  paying  attention  to  the  boundaries  of  the  bronchopulmonary  segment  and  without  separate  division  of  the  segmental  vessels  and  bronchi.  Anatomic  sublobar  resection,  in  contrast,  involves  identification  and  ligation  of  those  structures  and  complete  removal  of  one  or  more  bronchopulmonary  segments.  Although  segmentectomy  was  first  described  for  the  treatment  of  pulmonary  infection,  more  common  indications  include  lung  cancers  in  patients  who  are  unable  to  undergo  lobectomy  because  of  physiologic  constraints,  lung  metastases  not  amenable  to  simple  wedge  excision,  and  pulmonary  lesions  that  require  resection  and  cannot  be  easily  localized  intraoperatively  by  palpation  or  other  means  (Table  72-1).  Such  nodules  may  be  amenable  to  segmentectomy  by  virtue  of  their  known  location  in  a  specific  lung  segment  on  preoperative  CT  imaging.  The  latter  is  frequently  the  case  with  minimally  invasive  resection  of  nodules  located  deep  within  the  lung  parenchyma,  where  the  ability  to  palpate  the  lung  may  be  limited.  The  use  of  segmentectomy  for  small  lung  cancers  in  healthy  patients  who  could  tolerate  lobectomy  is  an  area  of  ongoing  controversy.