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Postsurgical residual lung complications following left upper trisegmentectomy
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- Yutaro Koike
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- Aritoshi Hattori
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- Takeshi Matsunaga
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- Kazuya Takamochi
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- Shiaki Oh
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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- Kenji Suzuki
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
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Description
<jats:title>Abstract</jats:title><jats:p/><jats:sec><jats:title>OBJECTIVES</jats:title><jats:p>Segmentectomy has become an increasingly popular surgical procedure for small-sized lung lesions. Left upper trisegmentectomy (LUTS) is one of the most common segmentectomies performed because of its relative ease and simplicity; however, limited information is currently available on the specific postoperative complications associated with this procedure.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>Among 2060 surgically resected cases in our institute between 2009 and 2016, 129 (6.2%) underwent LUTS. Postoperative chest X-rays and/or thoracic computed tomography (CT) scans were retrospectively assessed for all cases to assess postsurgical residual lung complications following LUTS. We categorized cases into 4 groups: type A (atelectasis of the lingular segment), type B (lung torsion of the lingular segment), type C (necrosis of the ‘isolated segment’) and type D (haematoma along stapling lines).</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>Postsurgical lung complications following LUTS were observed in 17 (13.1%) patients (type A: n = 7, type B: n = 1, type C: n = 4 and type D: n = 5). Three patients (2.3%) required surgical intervention because of type B (n = 1) and type C (n = 2), namely, decreased permeability and remaining ground glass opacities in the residual lung, showing an exacerbated systemic inflammatory response. In contrast, type A and D cases were successfully observed by chest CT without any surgical intervention, and patients recovered within a few months of surgery.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>We identified several postoperative residual lung complications following LUTS. Lung torsion or necrosis of the residual segment may require intensive care, including reoperation. Potentially serious complications always need to be ruled out after LUTS when radiological consolidation is detected postoperatively.</jats:p></jats:sec>
Journal
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- European Journal of Cardio-Thoracic Surgery
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European Journal of Cardio-Thoracic Surgery 2019-10-24
Oxford University Press (OUP)