Advanced Thoracoscopic Surgery to Modern Pulmonary Disease: The Japanese Approach

Kanzaki, Masato

doi:10.1007/978-1-4939-2671-8_23

Cited by 3 publications

(12 citation statements)

References 13 publications

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“…Thoracoscopic lung segmentectomy is rather challenging because the intersegmental border is di cult to identify and divide. However, we previously reported that 3D images reconstructed from CT data are useful for understanding the 3D branching pattern of the intersegmental pulmonary veins, allowing us to identify the intersegmental plane [4][5][6][7]. Conventional segmentectomy of the S9, S10, or both involves an interlobar ssure that cuts into the lung parenchyma between the superior segment and the S8.…”

Section: Discussionmentioning

confidence: 99%

“…The 3D branching pattern of the intersegmental pulmonary veins can be identi ed using 3D images reconstructed from CT data. Previously, our department reported a patient-speci c virtual 3D pulmonary model for thoracoscopic lung resections [4][5][6][7]. After plain chest CT slices of 1-mm thickness were obtained, HRCT images were converted into DICOM data, which were inputted into a personal computer.…”

Section: Discussionmentioning

confidence: 99%

“…Our department used virtual three-dimensional (3D) pulmonary reconstruction models for preoperative surgical planning. The reconstruction of individual 3D pulmonary models was previously described [4][5][6][7]. After HRCT examination, the imaging data were viewed in digital imaging and communications-inmedicine (DICOM) format.…”

Section: Preoperative Surgical Planningmentioning

confidence: 99%

“…The reconstructed 3D images of the pulmonary blood vessels, bronchi, and lung can be reshaped, transected, and moved even on a personal computer; thus, virtual surgical procedures and navigation during surgery can be simulated (Fig. 1) [4][5][6][7].…”

Section: Preoperative Surgical Planningmentioning

confidence: 99%

“…thoracotomy in both groups. The median chest tube duration was 4 (2-11) and 3(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days, and the median postoperative hospital stay was 7.5(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) and 8.0(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) days in the PL and IF groups, respectively. No intraoperative complication was noted in both groups.…”

mentioning

confidence: 99%

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Complete thoracoscopic S9 and/or S10 segmentectomy through a pulmonary ligament approach: a case control study

Mitsuboshi

Matsumoto

Omata

et al. 2022

Preprint

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Background The high resolution of computed tomography has found the pulmonary ligaments that consists of a double serous layer of visceral pleura, forms the intersegmental septum, and enters the lung parenchyma. This study aimed to investigate the clinical feasibility of thoracoscopic segmentectomy (TS) of the lateral basal segment (S9), posterior basal segment (S10), and both through the pulmonary ligament (PL). Methods Between February 2009 and November 2021, 542 patients underwent segmentectomy for malignant lung tumors at Tokyo Women’s Medical University Hospital (Tokyo, Japan). This study included 51 patients. Among them, 40 underwent a complete TS of the S9, S10, or both by the PL approach (PL group), and the remaining 11 by the interlobar fissure approach (IF group). Results Patients’ characteristics did not significantly differ between the two groups. In the PL group, 34 underwent video-assisted thoracoscopic surgery (VATS), and 6 underwent robot-assisted thoracoscopic surgery. In the IF group, all 11 underwent VATS. Operation duration, estimated blood loss, and postoperative complication frequency were not significantly different between these groups, but the maximum tumor diameter showed a significant difference. Local recurrence was observed in only 2 patients from the IF group. Conclusions Complete TS of the S9, S10, and both through the PL is a reasonable option for tumors located in such segments.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Preoperative Surgical Planningmentioning

confidence: 99%

Section: Preoperative Surgical Planningmentioning

confidence: 99%

mentioning

confidence: 99%

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Complete thoracoscopic S9 and/or S10 segmentectomy through a pulmonary ligament approach: a case control study

Mitsuboshi

Matsumoto

Omata

et al. 2022

Preprint

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Complete thoracoscopic S9 and/or S10 segmentectomy through a pulmonary ligament approach: a retrospective study

Mitsuboshi

Matsumoto

Omata

et al. 2023

J Cardiothorac Surg

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Background The high resolution of computed tomography has found the pulmonary ligaments that consists of a double serous layer of visceral pleura, forms the intersegmental septum, and enters the lung parenchyma. This study aimed to investigate the clinical feasibility of thoracoscopic segmentectomy (TS) of the lateral basal segment (S9), posterior basal segment (S10), and both through the pulmonary ligament (PL). Methods Between February 2009 and November 2021, 542 patients underwent segmentectomy for malignant lung tumors at Tokyo Women’s Medical University Hospital (Tokyo, Japan). This study included 51 patients. Among them, 40 underwent a complete TS of the S9, S10, or both by the PL approach (PL group), and the remaining 11 by the interlobar fissure approach (IF group). Results Patients’ characteristics did not significantly differ between the two groups. In the PL group, 34 underwent video-assisted thoracoscopic surgery (VATS), and 6 underwent robot-assisted thoracoscopic surgery. In the IF group, all 11 underwent VATS. Operation duration, estimated blood loss, and postoperative complication frequency were not significantly different between these groups, but the maximum tumor diameter showed a significant difference. Conclusions Complete TS of the S9, S10, and both through the PL is a reasonable option for tumors located in such segments. This approach is a feasible option for performing TS.

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Comparison of different approaches in complete thoracoscopic segmentectomy of lung lower lobe

Mitsuboshi¹,

Matsumoto²,

Omata³

et al. 2023

J Thorac Dis

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Background: Safe and oncologically acceptable segmentectomy outcomes were reported for earlystage lung cancer. The high-resolution computed tomography allowed us to find detailed structures inside the lungs, such as the pulmonary ligaments (PLs). Hence, we have presented the relatively anatomically challenging thoracoscopic segmentectomy, for the resection of the lateral basal segment, the posterior basal segment, and both segments through the PL as a PL approach. This study aimed to retrospectively examine the lung lower lobe segmentectomy, excluding the superior and basal segments (from S7 to S10), using the PL approach as an option to treat the lower lobe tumors of the lung. We then compared the efficacy of the PL approach in terms of safety with the interlobar fissure (IF) approach. The characteristics of the patients, intra-and postoperative complications, and surgical outcomes were analyzed.Methods: Of the 510 patients who underwent segmentectomy for malignant lung tumors from February 2009 to December 2020, 85 were included in this study. Among them, 41 underwent a complete lung lower lobe thoracoscopic segmentectomy, excluding S6 and basal segments (from S7 to S10), using the PL approach, and the remaining 44 used the IF approach.Results: The median age in 41 patients in the PL group was 64.0 years (range, 22-82 years), and that in 44 patients in the IF group was 66.5 years (range, 44-88 years), with significant differences in gender between these groups. Video-assisted thoracoscopic surgery and robot-assisted thoracoscopic surgery were performed on 37 and 4 patients in the PL group and 43 and 1 patient in the IF group, respectively.Postoperative complication frequency was not significantly different between these groups. The most common complications were the air leaks that persisted for over 7 days in 1 and 5 patients in the PL and IF groups, respectively.Conclusions: Complete thoracoscopic segmentectomy of the lower lobe, excluding S6 and basal segments, using the PL approach is a reasonable option for lung lower lobe tumors compared with the IF approach.

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Advanced Thoracoscopic Surgery to Modern Pulmonary Disease: The Japanese Approach

Cited by 3 publications

References 13 publications

Complete thoracoscopic S9 and/or S10 segmentectomy through a pulmonary ligament approach: a case control study

Complete thoracoscopic S9 and/or S10 segmentectomy through a pulmonary ligament approach: a case control study

Complete thoracoscopic S9 and/or S10 segmentectomy through a pulmonary ligament approach: a retrospective study

Comparison of different approaches in complete thoracoscopic segmentectomy of lung lower lobe

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