Uniportal thoracoscopic anatomical sub-segmentectomy of the basal segment: A retrospective cohort study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

JIN Xing , CHEN Lei , DUAN Shanzhou , SANG Yonghua , CHEN Yongbing ,  ZHU Xuejuan

Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, Jiangsu, P. R. China;

Corresponding author：

ZHU Xuejuan, Email: zxj995062@163.com

Keywords：

Uniport; segmentectomy; video-assisted thoracoscopic surgery (VATS); retrospective cohort study

DOI：

10.7507/1007-4848.202106069

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the clinical experience of the uniportal thoracoscopic anatomical sub-segmentectomy of the basal segment. Methods The clinical data of 34 patients who underwent uniportal thoracoscopic anatomical sub-segmentectomy of the basal segment in our department between April 2018 and April 2021 were retrospectively analyzed. There were 19 males and 15 females with a median age of 56.5 (28.0-76.0) years, a 3-4 cm incision was made in the 5th intercostal area at the front axillary line, and anatomical sub-segmentectomy of the basal segment was performed. Results The surgery was successfully performed in all patients, and there was no patient with additional chest incision or transfer to thoracotomy. The median operation time was 165.0 (125.0-220.0) min, intraoperative blood loss was 120.0 (70.0-290.0) mL, thoracic drainage time was 3.5 (2.0-24.0) d, and hospitalization time was 6.0 (3.0-26.0) d. There was no death during the hospitalization. Postoperative complications included 4 patients of atrial fibrillation, 2 patients of blood sputum, 3 patients of persistent air leakage, and they were recovered after conservative treatment. One patient developed pneumothorax after discharge, 1 patient developed pleural effusion, and both of them recovered after drainage. Postoperative pathology showed microinvasive adenocarcinoma in 22 patients, adenocarcinoma in situ in 7 patients, benign tumors in 5 patients. The lymph nodes were negative in all patients. Conclusion The uniportal thoracoscopic anatomical sub-segmentectomy of the basal segment is safe and feasible, and can be popularized and applied in clinic.

Citation： JIN Xing, CHEN Lei, DUAN Shanzhou, SANG Yonghua, CHEN Yongbing, ZHU Xuejuan. Uniportal thoracoscopic anatomical sub-segmentectomy of the basal segment: A retrospective cohort study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(10): 1313-1318. doi: 10.7507/1007-4848.202106069 Copy

1.	Zhang Y, Jheon S, Li H, et al. Results of low-dose computed tomography as a regular health examination among Chinese hospital employees. J Thorac Cardiovasc Surg, 2020, 160(3): 824-831.
2.	Bedetti B, Bertolaccini L, Rocco R, et al. Segmentectomy versus lobectomy for stage Ⅰ non-small cell lung cancer: A systematic review and meta-analysis. J Thorac Dis, 2017, 9(6): 1615-1623.
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5.	Nomori H, Mori T, Shiraishi A, et al. Long-term prognosis after segmentectomy for cT1N0M0 non-small cell lung cancer. Ann Thorac Surg, 2019, 107(5): 1500-1506.
6.	Wu X, Li T, Zhang C, et al. Comparison of perioperative outcomes between precise and routine segmentectomy for patients with early-stage lung cancer presenting as ground-glass opacities: A propensity score-matched study. Front Oncol, 2021, 11: 661821.
7.	Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
8.	Martin-Ucar AE, Nakas A, Pilling JE, et al. A case-matched study of anatomical segmentectomy versus lobectomy for stage Ⅰ lung cancer in high-risk patients. Eur J Cardiothorac Surg, 2005, 27(4): 675-679.
9.	Landreneau RJ, Normolle DP, Christie NA, et al. Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage Ⅰ non-small-cell lung cancer: A propensity-matched analysis. J Clin Oncol, 2014, 32(23): 2449-2455.
10.	Li T, Xia L, Wang J, et al. Uniportal versus three-port video-assisted thoracoscopic surgery for non-small cell lung cancer: A retrospective study. Thorac Cancer, 2021, 12(8): 1147-1153.
11.	Mizukami Y, Takahashi Y, Adachi H. Single-port vs. conventional three-port video-assisted thoracoscopic pulmonary wedge resection: Comparison of postoperative pain and surgical costs. Ann Thorac Cardiovasc Surg, 2021, 27(2): 91-96.
12.	Matsuura N, Igai H, Ohsawa F, et al. Safety and feasibility of uniportal video-assisted thoracoscopic uncommon segmentectomy. J Thorac Dis, 2021, 13(5): 3001-3009.
13.	Gonzalez-Rivas D, Fieira E, Mendez L, et al. Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. Eur J Cardiothorac Surg, 2012, 42(6): e169-e171.
14.	Pu Q, Liu C, Guo C, et al. Stem-branch: A novel method for tracking the anatomy during thoracoscopic S9-10 segmentectomy. Ann Thorac Surg, 2019, 108(5): e333-e335.
15.	Yamanashi K, Okumura N, Otsuki Y, et al. Stapler-based thoracoscopic basilar segmentectomy. Ann Thorac Surg, 2017, 104(5): e399-e402.

1. Zhang Y, Jheon S, Li H, et al. Results of low-dose computed tomography as a regular health examination among Chinese hospital employees. J Thorac Cardiovasc Surg, 2020, 160(3): 824-831.
2. Bedetti B, Bertolaccini L, Rocco R, et al. Segmentectomy versus lobectomy for stage Ⅰ non-small cell lung cancer: A systematic review and meta-analysis. J Thorac Dis, 2017, 9(6): 1615-1623.
3. 中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2019版). 中华肿瘤杂志, 2020, 42(4): 257-287.
4. Hennon M, Landreneau RJ. Role of segmentectomy in treatment of early-stage non-small cell lung cancer. Ann Surg Oncol, 2018, 25(1): 59-63.
5. Nomori H, Mori T, Shiraishi A, et al. Long-term prognosis after segmentectomy for cT1N0M0 non-small cell lung cancer. Ann Thorac Surg, 2019, 107(5): 1500-1506.
6. Wu X, Li T, Zhang C, et al. Comparison of perioperative outcomes between precise and routine segmentectomy for patients with early-stage lung cancer presenting as ground-glass opacities: A propensity score-matched study. Front Oncol, 2021, 11: 661821.
7. Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
8. Martin-Ucar AE, Nakas A, Pilling JE, et al. A case-matched study of anatomical segmentectomy versus lobectomy for stage Ⅰ lung cancer in high-risk patients. Eur J Cardiothorac Surg, 2005, 27(4): 675-679.
9. Landreneau RJ, Normolle DP, Christie NA, et al. Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage Ⅰ non-small-cell lung cancer: A propensity-matched analysis. J Clin Oncol, 2014, 32(23): 2449-2455.
10. Li T, Xia L, Wang J, et al. Uniportal versus three-port video-assisted thoracoscopic surgery for non-small cell lung cancer: A retrospective study. Thorac Cancer, 2021, 12(8): 1147-1153.
11. Mizukami Y, Takahashi Y, Adachi H. Single-port vs. conventional three-port video-assisted thoracoscopic pulmonary wedge resection: Comparison of postoperative pain and surgical costs. Ann Thorac Cardiovasc Surg, 2021, 27(2): 91-96.
12. Matsuura N, Igai H, Ohsawa F, et al. Safety and feasibility of uniportal video-assisted thoracoscopic uncommon segmentectomy. J Thorac Dis, 2021, 13(5): 3001-3009.
13. Gonzalez-Rivas D, Fieira E, Mendez L, et al. Single-port video-assisted thoracoscopic anatomic segmentectomy and right upper lobectomy. Eur J Cardiothorac Surg, 2012, 42(6): e169-e171.
14. Pu Q, Liu C, Guo C, et al. Stem-branch: A novel method for tracking the anatomy during thoracoscopic S9-10 segmentectomy. Ann Thorac Surg, 2019, 108(5): e333-e335.
15. Yamanashi K, Okumura N, Otsuki Y, et al. Stapler-based thoracoscopic basilar segmentectomy. Ann Thorac Surg, 2017, 104(5): e399-e402.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Uniportal thoracoscopic anatomical sub-segmentectomy of the basal segment: A retrospective cohort study in a single center

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