Radical Segmentectomy Through Minimally Invasive Approach for Lung Cancer

Okada Morihito

doi:10.2482/haigan.45.261

The significant principle of surgical intervention in practice for lung cancer is considered striking a balance between oncological radicality and less invasive surgery. The former is a major premise and the latter consists of lesser parenchyma resection and minimally invasive approach. During the past decades, the common technique for primary non-small cell lung cancers has been an anatomic lobectomy and a complete hilar/mediastinal dissection using traditional open thoracotomy with very few and very infrequent variations. This is still recommended even though small-sized peripheral cancers are increasingly detected with recent advances in radiologic investigation. We have great doubts as to whether the conventional procedure is really necessary for treatment of small lesions, and so extended segmentectomy with lymph node assessment can be generated as an alternative to lobectomy for clinical stage I cancers 2 cm or smaller. Although video-assisted thoracic surgery (VATS) can be performed more with the introduction of minimally invasive access, arguments among thoracic surgeons continue regarding the appropriateness of “pure” VATS to pulmonary resection for lung cancer. We have made some refinements concerning the access to apply the benefits to as many cases as we can, and thus utilize a integrated combination of muscle-sparing minithoracotomy with video-assisted technique (Hybrid VATS). Current general trends toward less invasive techniques imply that great changes of surgical practice could take place for lung cancer.

Radical Segmentectomy Through Minimally Invasive Approach for Lung Cancer

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