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Ward V. Houck
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Ann Thorac Surg 2004;78:1858-1860
© 2004 The Society of Thoracic Surgeons

How to do it

Video-Assisted Thoracic Surgery Upper Lobe Trisegmentectomy for Early-Stage Left Apical Lung Cancer

Ward V. Houck, MDa, Clark B. Fuller, MDa, Robert J. McKenna, Jr, MDa,*

a Department of Thoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA

Accepted for publication September 11, 2003.

* Address reprint requests to Dr McKenna, Department of Thoracic Surgery, Cedars-Sinai Medical Center, 8635 W Third, Ste 975W, Los Angeles, CA, USA 90048
mckennar{at}cshs.org

Resection of the left upper lobe with preservation of the lingula is the anatomic equivalent of a right upper lobectomy with preservation of the right middle lobe. Therefore, our standard operation for a small apical tumor in the left upper lobe has been an apical trisegmentectomy. The purpose of this article is to review our experience with the procedure by video-assisted thoracic surgery (VATS) and to describe the operative technique for a VATS apical trisegmentectomy. Eleven patients underwent the procedure with no deaths, low morbidity, and good initial disease-free survival. A VATS apical trisegmentectomy seems to be a feasible and reasonable treatment for small stage I lung cancers at the apex of the left upper lobe.




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