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Comparison of surgical outcomes between thoracoscopic anatomical sublobar resection including and excluding subsegmentectomy

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Abstract

Objectives

Despite the ubiquitous utilization of anatomical sublobar resection for malignant lung tumors, the effectiveness and feasibility of subsegmentectomy remains unclear. This study therefore compared the perioperative outcomes between anatomical sublobar resection including (IS) and excluding (ES) subsegmentectomy.

Methods

Patients who had undergone anatomical sublobar resection at our institution from January 2013 to March 2019 were retrospectively reviewed. Clinicopathologic characteristics and perioperative outcomes of the IS group (n = 58) were then analyzed the compared to those of the ES group (n = 203).

Results

No statistically significant differences in age, sex, comorbidities, tumor location, preoperative pulmonary function, or tumor size on imaging were found between both groups. The IS group had significantly higher preoperative computed tomography-guided marking rates (40% vs. 18%; p < 0.01) and used significantly more staplers for intersegmental dissection than the ES group [4, interquartile range (IQR): 3–4 vs. 3, IQR: 3–4; p = 0.03]. Both groups had comparable 30-day mortality (0% vs. 0%; p > 0.99), intraoperative complications (7% vs. 10%; p = 0.61), and postoperative complications (5% vs. 8%; p = 0.58). After propensity score matching, the IS group experienced significantly lesser blood loss than the ES group (5 mL, IQR: 1–10 vs. 5 mL, IQR: 5–20; p = 0.03). Both groups experienced no local recurrence and demonstrated similar postoperative pulmonary functions after surgery.

Conclusions

IS may be a feasible and acceptable therapeutic option for malignant lung tumors. Nonetheless, future investigations are required to further validate the current findings.

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Abbreviations

CT:

Computed tomography

ES:

Anatomical sublobar resection excluding subsegmentectomy

FEV1 :

Forced expiratory volume in 1.0 s

FVC:

Forced vital capacity

IQR:

Interquartile range

IS:

Anatomical sublobar resection including subsegmentectomy

MRI:

Magnetic resonance imaging

NSCLC:

Non-small cell lung cancer

PET:

Positron emission tomography

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Authors and Affiliations

  1. Department of Thoracic Surgery, Aichi Cancer Center, 1-1 Kanokoden Chikusa-ku, Nagoya, 464-8681, Japan

    Takuya Matsui, Yusuke Takahashi, Suguru Shirai, Keita Nakanishi, Takeo Nakada, Noriaki Sakakura & Hiroaki Kuroda

  2. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho Mizuho-ku, Nagoya, 467-8602, Japan

    Takuya Matsui, Hiroshi Haneda, Katsuhiro Okuda & Ryoichi Nakanishi

Authors
  1. Takuya Matsui
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  2. Yusuke Takahashi
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  3. Suguru Shirai
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  4. Keita Nakanishi
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  5. Takeo Nakada
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  9. Ryoichi Nakanishi
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  10. Hiroaki Kuroda
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Correspondence to Yusuke Takahashi.

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Matsui, T., Takahashi, Y., Shirai, S. et al. Comparison of surgical outcomes between thoracoscopic anatomical sublobar resection including and excluding subsegmentectomy. Gen Thorac Cardiovasc Surg 69, 850–858 (2021). https://doi.org/10.1007/s11748-020-01556-3

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  • DOI: https://doi.org/10.1007/s11748-020-01556-3

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