Skip to main content

Advertisement

SpringerLink
Log in

Feasibility of repeated ipsilateral anatomical pulmonary resection

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to elucidate the feasibility of repeated ipsilateral anatomical pulmonary resection.

Methods

The subjects of this retrospective analysis were 50 patients who underwent ipsilateral anatomical pulmonary resection after major lung surgery. The patients were divided into two groups according to the type of primary operation performed: a repeated anatomical pulmonary resection group (RA group; n = 24) and an anatomical pulmonary resection after wedge resection group (AW group; n = 26). We compared the perioperative outcomes of the two groups.

Results

Completion lobectomy was performed in 9 of the 24 patients (38%) from the RA group and adhesion of the pulmonary hilum was more severe in this group (P = 0.004). Although the operative time was significantly longer in the RA group (P = 0.030), there was no significant difference in the amount of blood loss (P = 0.217) between the groups. A significantly higher rate of severe postoperative complications was observed in the RA group (42%) than in the AW group (12%) (P = 0.024). None of the patients who underwent repeated surgery died within 90 days postoperatively.

Conclusion

Although repeated anatomical pulmonary resection is a more challenging procedure than anatomical resection after wedge resection, it does not increase short-term mortality; therefore, it is a feasible treatment option.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article  PubMed  Google Scholar 

  2. Ito H, Suzuki K, Mizutani T, Aokage K, Wakabayashi M, Fukuda H, et al. Long-term survival outcome after lobectomy in patients with clinical T1 N0 lung cancer. J Thorac Cardiovasc Surg. 2021;161:281–90.

    Article  Google Scholar 

  3. Flores R, Bauer T, Aye R, Andaz S, Kohman L, Sheppard B, et al. Balancing curability and unnecessary surgery in the context of computed tomography screening for lung cancer. J Thorac Cardiovasc Surg. 2014;147:1619–26.

    Article  PubMed  Google Scholar 

  4. Keenan RJ, Landreneau RJ, Maley RH Jr, Singh D, Macherey R, Bartley S, et al. Segmental resection spares pulmonary function in patients with stage I lung cancer. Ann Thorac Surg. 2004;78:228–33.

    Article  PubMed  Google Scholar 

  5. Hamaji M, Allen MS, Cassivi SD, Deschamps C, Nichols FC, Wigle DA, et al. Surgical treatment of metachronous second primary lung cancer after complete resection of non-small cell lung cancer. J Thorac Cardiovasc Surg. 2013;145:683–90.

    Article  PubMed  Google Scholar 

  6. Kamigaichi A, Tsutani Y, Fujiwara M, Mimae T, Miyata Y, Okada M. Postoperative recurrence and survival after segmentectomy for clinical stage 0 or IA lung cancer. Clin Lung Cancer. 2019;20:397–403.

    Article  PubMed  Google Scholar 

  7. Kamigaichi A, Tsutani Y, Kagimoto A, Fujiwara M, Mimae T, Miyata Y, et al. Comparing segmentectomy and lobectomy for clinical stage IA solid-dominant lung cancer measuring 2.1 to 3 cm. Clin Lung Cancer. 2020;21:e528–38.

    Article  PubMed  Google Scholar 

  8. Kamigaichi A, Tsutani Y, Mimae T, Miyata Y, Ito H, Nakayama H, et al. Prognosis of segmentectomy and lobectomy for radiologically aggressive small-sized lung cancer. Eur J Cardiothorac Surg. 2020;58:1245–53.

    Article  PubMed  Google Scholar 

  9. Nishio W, Yoshimura M, Maniwa Y, Kitamura Y, Tane K, Takenaka D, et al. Re- assessment of intentional extended segmentectomy for clinical t1an0 non-small cell lung cancer. Ann Thorac Surg. 2016;102:1702–10.

    Article  PubMed  Google Scholar 

  10. Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022;399:1607–17.

    Article  CAS  PubMed  Google Scholar 

  11. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70:145–64.

    Article  PubMed  Google Scholar 

  12. Hattori A, Matsunaga T, Watanabe Y, Fukui M, Takamochi K, Oh S, et al. Repeated anatomical pulmonary resection for metachronous ipsilateral second non-small cell lung cancer. J Thorac Cardiovasc Surg. 2021;162:1389–98.

    Article  PubMed  Google Scholar 

  13. Omasa M, Date H, Takamochi K, Suzuki K, Miyata Y, Okada M. Completion lobectomy after radical segmentectomy for pulmonary malignancies. Asian Cardiovasc Thorac Ann. 2016;24:450–4.

    Article  PubMed  Google Scholar 

  14. Takahashi Y, Miyajima M, Tada M, Maki R, Mishina T, Watanabe A. Outcomes of completion lobectomy long after segmentectomy. J Cardiothorac Surg. 2019;14:116.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Okada M, Tsutani Y, Ikeda T, Misumi K, Matsumoto K, Yoshimura M, et al. Radical hybrid video-assisted thoracic segmentectomy: long-term results of minimally invasive anatomical sublobar resection for treating lung cancer. Interact Cardiovasc Thorac Surg. 2012;14:5–11.

    Article  PubMed  Google Scholar 

  16. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Puri V, Tran A, Bell JM, Crabtree TD, Kreisel D, Krupnick AS, et al. Completion pneumonectomy: outcomes for benign and malignant indications. Ann Thorac Surg. 2013;95:1885–91.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Linden PA, Yeap BY, Chang MY, Henderson WG, Jaklitsch MT, Khuri S, et al. Morbidity of lung resection after prior lobectomy: results from the veterans affairs national surgical quality improvement program. Ann Thorac Surg. 2007;83:425–31.

    Article  PubMed  Google Scholar 

  19. Crabtree T, Puri V, Timmerman R, Fernando H, Bradley J, Decker PA, et al. Treatment of stage I lung cancer in high-risk and inoperable patients: comparison of prospective clinical trials using stereotactic body radiotherapy (RTOG 0236), sublobar resection (ACOSOG Z4032), and radiofrequency ablation (ACOSOG Z4033). J Thorac Cardiovasc Surg. 2013;145:692–9.

    Article  PubMed  Google Scholar 

  20. Chang JY, Senan S, Paul MA, Mehran RJ, Louie AV, Balter P, et al. Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. Lancet Oncol. 2015;16:630–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Timmerman RD, Paulus R, Pass HI, Gore EM, Edelman MJ, Galvin J, et al. Stereotactic body radiation therapy for operable early-stage lung cancer: findings from the NRG oncology RTOG 0618 trial. JAMA Oncol. 2018;4:1263–6.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Atsushi Kamigaichi, Yasuhiro Tsutani, Yoshinori Handa, Takahiro Mimae, Yoshihiro Miyata & Morihito Okada

Authors
  1. Atsushi Kamigaichi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasuhiro Tsutani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshinori Handa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takahiro Mimae
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshihiro Miyata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Morihito Okada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Morihito Okada.

Ethics declarations

Conflict of interest

We have no conflicts of interest to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kamigaichi, A., Tsutani, Y., Handa, Y. et al. Feasibility of repeated ipsilateral anatomical pulmonary resection. Surg Today 53, 379–385 (2023). https://doi.org/10.1007/s00595-022-02604-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-022-02604-6

Keywords

Search

Navigation