Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer.
Role of sublobar resection (segmentectomy and wedge resection) in the surgical management of non-small cell lung cancer.
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DOI：
10.1016/j.thorsurg.2007.03.002
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发表时间：
2007-05-01
影响因子：
2.1
通讯作者：
Landreneau, Rodney J
中科院分区：
文献类型：
--
作者：
Pettiford, Brian L;Schuchert, Matthew J;Landreneau, Rodney J
肺段切除术需要对肺的三维支气管血管解剖有透彻的了解。这种解剖细节使节段切除术比肺叶切除术更具挑战性。在进行节段性肺切除时，应遵循以下原则：(1)避免在发育不良的裂隙中剥离；(2)在肺段间平面分割肺实质时，应以横断的支气管为基础；(3)考虑使用内吻合器分离肺实质，以减少与节段间平面“指状骨折”剥离相关的漏气并发症；(4)考虑使用辅助性碘125近距离放射治疗，以减少叶下切除后局部复发。越来越多的证据支持在适当选择的患者中使用解剖节段切除术治疗原发性肺癌。这种切除方法似乎最适合于小(
Segmentectomy demands a thorough knowledge of the three-dimensional bronchovascular anatomy of the lung. This anatomic detail makes segmentectomy significantly more challenging than lobectomy. Several principles must be applied when performing segmental lung resection: (1) the surgeon should avoid dissection in a poorly developed fissure, (2) use the transected bronchus as the base of the segmental resection during the division of the lung parenchymal in the intersegmental plane, (3) consider the use of endostapler division of the pulmonary parenchyma to reduce the air leak complications related to "finger fracture" dissection of the intersegmental plane, and (4) consider the use of adjuvant iodine 125 brachytherapy as a means of reducing local recurrence following sublobar resection. Increasing evidence supports the use of anatomic segmentectomy in the treatment of primary lung cancer for appropriately selected patients. This resection approach seems most appropriate in the management of the small (