Clinical application of uniportal video-assisted thoracoscopic surgery anatomic basal segmentectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

NIU Lingli , LIU Chengwu , WANG Wenping , ZHANG Xiaolong ,  LIU Lunxu

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Video-assisted thoracoscopic surgery (VATS); uniportal thoracoscopy; segmentectomy; lung cancer

DOI：

10.7507/1007-4848.202012125

Video：

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Objective To investigate the efficacy of uniportal video-assisted thoracoscopic surgery (VATS) anatomic basal segmentectomy.Methods The clinical data of 15 patients who underwent uniportal VATS anatomic basal segmentectomy between June 2020 and December 2020 were retrospectively reviewed. There were 4 males and 11 females with a median age of 53 (32-70) years. The incisions were placed in the fifth intercostal space across the mid-axillary line. All basal segmentectomies were performed through the interlobar fissure or inferior pulmonary ligament approach following the strategies of single-direction and stem-branch.Results All patients underwent basal segmentectomy successfully with no conversion to multi-portal procedure or thoracotomy. The median operation time was 120 (90-160) min, median intraoperative blood loss was 20 (10-50) mL, median drainage time was 3 (2-5) d, and median postoperative hospital stay was 4 (4-10) d. The maximum diameter of the lesion in the resected basal segment was 1.2 (0.7-1.9) cm. The median resected lymph nodes were 7 (5-12). There was no evidence of nodal metastases. One patient suffered postoperative atelectasis and subsequent pneumonia. No perioperative death occurred.Conclusion Uniportal VATS anatomic basal segmentectomy is feasible and safe. It can be performed in a simple manner following the strategy of single-direction.

Citation： NIU Lingli, LIU Chengwu, WANG Wenping, ZHANG Xiaolong, LIU Lunxu. Clinical application of uniportal video-assisted thoracoscopic surgery anatomic basal segmentectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(6): 725-728. doi: 10.7507/1007-4848.202012125 Copy

1.	Sato M, Murayama T, Nakajima J. Thoracoscopic stapler-based "bidirectional" segmentectomy for posterior basal segment (S10) and its variants. J Thorac Dis, 2018, 10(Suppl 10): S1179-S1186.
2.	Igai H, Kamiyoshihara M, Kawatani N, et al. Thoracoscopic lateral and posterior basal (S9 + 10) segmentectomy using intersegmental tunnelling. Eur J Cardiothorac Surg, 2017, 51(4): 790-791.
3.	Endoh M, Oizumi H, Kato H, et al. Posterior approach to thoracoscopic pulmonary segmentectomy of the dorsal basal segment: A single-institute retrospective review. J Thorac Cardiovasc Surg, 2017, 154(4): 1432-1439.
4.	Kikkawa T, Kanzaki M, Isaka T, et al. Complete thoracoscopic S9 or S10 segmentectomy through a pulmonary ligament approach. J Thorac Cardiovasc Surg, 2015, 149(3): 937-939.
5.	Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
6.	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.
7.	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.
8.	Zheng B, Xu G, Fu X, et al. Management of the inter-segmental plane using the "Combined Dimensional Reduction Method" is safe and viable in uniport video-assisted thoracoscopic pulmonary segmentectomy. Transl Lung Cancer Res, 2019, 8(5): 658-666.
9.	Zhang G, Yu Z, Wang L, et al. Uniportal video-assisted thoracoscopic S8 segmentectomy and S1a subsegmentectomy for synchronous multiple primary lung cancers. J Thorac Dis, 2018, 10(7): 4475-4480.
10.	Galvez C, Lirio F, Sesma J, et al. Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8). J Vis Surg, 2017, 3: 114.
11.	Ojanguren A, Sauvain MO, Gonzalez M. Uniportal ligamentum-based approach to posterolateral segments 9 and 10. Multimed Man Cardiothorac Surg, 2020.
12.	Ojanguren A, Forster C, Gonzalez M. Uniportal VATS fissure-based approach to segments 9 and 10. Multimed Man Cardiothorac Surg, 2020.
13.	Ojanguren A, Forster C, Gonzalez M. Uniportal VATS laterobasal segmentectomy (S9) of right lower lobe. Multimed Man Cardiothorac Surg, 2020.
14.	Guo C, Liu C, Lin F, et al. Intrathoracic vertical overhanging approach for placement of an endo-stapler during single-port video-assisted thoracoscopic lobectomy. Eur J Cardiothorac Surg, 2016, 49 (Suppl 1): i84-i86.
15.	Wang J, Xu X, Wen W, et al. Modified method for distinguishing the intersegmental border for lung segmentectomy. Thorac Cancer, 2018, 9(2): 330-333.
16.	Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg, 2020, 110(6): 1796-1804.
17.	Sagawa M, Oizumi H, Suzuki H, et al. A prospective 5-year follow-up study after limited resection for lung cancer with ground-glass opacity. Eur J Cardiothorac Surg, 2018, 53(4): 849-856.
18.	Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical Ⅰ A lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.

1. Sato M, Murayama T, Nakajima J. Thoracoscopic stapler-based "bidirectional" segmentectomy for posterior basal segment (S10) and its variants. J Thorac Dis, 2018, 10(Suppl 10): S1179-S1186.
2. Igai H, Kamiyoshihara M, Kawatani N, et al. Thoracoscopic lateral and posterior basal (S9 + 10) segmentectomy using intersegmental tunnelling. Eur J Cardiothorac Surg, 2017, 51(4): 790-791.
3. Endoh M, Oizumi H, Kato H, et al. Posterior approach to thoracoscopic pulmonary segmentectomy of the dorsal basal segment: A single-institute retrospective review. J Thorac Cardiovasc Surg, 2017, 154(4): 1432-1439.
4. Kikkawa T, Kanzaki M, Isaka T, et al. Complete thoracoscopic S9 or S10 segmentectomy through a pulmonary ligament approach. J Thorac Cardiovasc Surg, 2015, 149(3): 937-939.
5. Liu C, Liao H, Guo C, et al. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg, 2020, 160(6): 1586-1594.
6. 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.
7. 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.
8. Zheng B, Xu G, Fu X, et al. Management of the inter-segmental plane using the "Combined Dimensional Reduction Method" is safe and viable in uniport video-assisted thoracoscopic pulmonary segmentectomy. Transl Lung Cancer Res, 2019, 8(5): 658-666.
9. Zhang G, Yu Z, Wang L, et al. Uniportal video-assisted thoracoscopic S8 segmentectomy and S1a subsegmentectomy for synchronous multiple primary lung cancers. J Thorac Dis, 2018, 10(7): 4475-4480.
10. Galvez C, Lirio F, Sesma J, et al. Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8). J Vis Surg, 2017, 3: 114.
11. Ojanguren A, Sauvain MO, Gonzalez M. Uniportal ligamentum-based approach to posterolateral segments 9 and 10. Multimed Man Cardiothorac Surg, 2020.
12. Ojanguren A, Forster C, Gonzalez M. Uniportal VATS fissure-based approach to segments 9 and 10. Multimed Man Cardiothorac Surg, 2020.
13. Ojanguren A, Forster C, Gonzalez M. Uniportal VATS laterobasal segmentectomy (S9) of right lower lobe. Multimed Man Cardiothorac Surg, 2020.
14. Guo C, Liu C, Lin F, et al. Intrathoracic vertical overhanging approach for placement of an endo-stapler during single-port video-assisted thoracoscopic lobectomy. Eur J Cardiothorac Surg, 2016, 49 (Suppl 1): i84-i86.
15. Wang J, Xu X, Wen W, et al. Modified method for distinguishing the intersegmental border for lung segmentectomy. Thorac Cancer, 2018, 9(2): 330-333.
16. Zhang Y, Fu F, Chen H. Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg, 2020, 110(6): 1796-1804.
17. Sagawa M, Oizumi H, Suzuki H, et al. A prospective 5-year follow-up study after limited resection for lung cancer with ground-glass opacity. Eur J Cardiothorac Surg, 2018, 53(4): 849-856.
18. Suzuki K, Koike T, Asakawa T, et al. A prospective radiological study of thin-section computed tomography to predict pathological noninvasiveness in peripheral clinical Ⅰ A lung cancer (Japan Clinical Oncology Group 0201). J Thorac Oncol, 2011, 6(4): 751-756.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical application of uniportal video-assisted thoracoscopic surgery anatomic basal segmentectomy

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