HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nakamoto, K. Search for Related Content PubMed PubMed Citation Articles by Nakamoto, K. Related Collections Lung - cancer Related Article

---

Original Articles: General Thoracic

Superselective Segmentectomy for Deep and Small Pulmonary Nodules Under the Guidance of Three-Dimensional Reconstructed Computed Tomographic Angiography

^a Division of General Thoracic Surgery, Memorial Shunan Hospital, Kudamatsu City, Yamaguchi, Japan
^b Division of General Thoracic Surgery, National Kure Medical Center, Hiroshima, Japan
^c Department of Surgery, National Ehime Hospital, Tou-on city, Ehime, Japan

Accepted for publication November 12, 2009.

^_* Address correspondence to Dr Nakamoto, Division of General Thoracic Surgery, Memorial Shunan Hospital, 1-10-1 Ikunoya minami, Kudamatsu city, Yamaguchi 744-0033, Japan (Email: nakamoto{at}hcsdojinkai.or.jp).

Background: Three-dimensional computed tomographic angiography (3D-CT angio) allows selective access to peripheral segments. Superselective segmentectomy (SSS) was applied to the surgical management of indeterminate small and deep pulmonary nodules.

Methods: Thirty patients with indeterminate pulmonary nodules less than 25 mm in diameter and located deeper than 20mm from the pleural surface were enrolled in this study between 2002 and 2009. All patients underwent exploratory thoracotomy. The SSS with a surgical margin from the nodule larger than the nodule diameter or 20 mm was directed toward the target pulmonary arteries by 3D-CT angio using a multidetector-row CT scanner. The SSS was evaluated for resected area, surgical margin, regional lymph nodes, morbidity, lung function, and survival rate.

Results: Three patients received SSS at the daughter segment, 23 patients that at the subsegment, and the remaining four underwent miscellaneous SSS without major complications. Twenty patients exhibited early lung cancer, one patient stage IIA lung cancer, and the remaining nine patients had metastatic or benign tumors. Five patients with primary cancer subsequently underwent standard lobectomy. The remaining 16 patients with early lung cancer did not undergo lobectomy because of their major comorbidities or refusal of a second thoracotomy. The surgical margins were free of disease in all patients. The actual and disease-free five-year survival rates were 100% for the lung cancer patients, excluding those who subsequently underwent lobectomy. The lung function after SSS was well preserved.

Conclusions: Superselective segmentectomy is an applicable optional strategy for the surgical management of indeterminate small and deep pulmonary nodules.

Related Article

Invited Commentary

Paul Schipper
Ann. Thorac. Surg. 2010 89: 883-884. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				D. Gossot, R. Ramos, E. Brian, C. Raynaud, P. Girard, and C. Strauss A totally thoracoscopic approach for pulmonary anatomic segmentectomies Interact CardioVasc Thorac Surg, April 1, 2011; 12(4): 529 - 533. [Abstract] [Full Text] [PDF]

				N. Misaki, S. S. Chang, H. Igai, S. Tarumi, M. Gotoh, and H. Yokomise New clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system J. Thorac. Cardiovasc. Surg., October 1, 2010; 140(4): 752 - 756. [Abstract] [Full Text] [PDF]

				P. Schipper Invited Commentary Ann. Thorac. Surg., March 1, 2010; 89(3): 883 - 884. [Full Text] [PDF]