10.25373/CTSNET.17064305.V1
Keita Tokuishi
Keita
Tokuishi
Takayuki Imakiire
Takayuki
Imakiire
Satoshi Yoneda
Satoshi
Yoneda
Toshihiko Sato
Toshihiko
Sato
Robotic Right Lower Lobe Anterobasal (S8) Segmentectomy
<p>Segmentectomy is indicated in selected patients with
non-small-cell lung cancer with peripheral nodules measuring ≤ 2 cm and a ≥ 50%
ground-glass appearance on computed tomography (CT) (1). We report the case of
an 80-year-old asymptomatic man with a history of symptomatic epilepsy, who
underwent CT for an unrelated condition and was shown to have a peripheral lung
nodule (1.5 cm) in the right S8 segment with a 50% ground-glass appearance.
Positron emission tomography-CT revealed that the maximum standardized uptake
value of the nodule was 2.2, without fluorodeoxyglucose uptake at any other
site. The patient underwent robotic right lower lobe anterobasal segmentectomy.</p>
<p>The chest tube was removed on postoperative day 2, and the
patient was discharged uneventfully. Histopathological examination showed
adenocarcinoma stage pT1aN0M0.</p>
<p> </p>
<p>Following are the recommendations we wish to highlight:</p>
<p>1. Careful and detailed preoperative CT evaluation is
essential to confirm the anatomical structures and their orientation in a
patient</p>
<p>2. Adequate dissection of the pulmonary artery should be
performed to accurately determine the anatomy of the relevant structures</p>
<p>3. Bronchoscopic evaluation is helpful to accurately
identify the target bronchus</p>
<p>4. Indocyanine green fluorescence imaging is an easy and
effective method to identify the segmental boundary</p>
<p>5. If possible, the peripheral bronchial stump should be
pulled toward the site of resection during parenchymal separation (lung segment
resection) using a linear cutter stapler</p>
<p>Reference</p>
<p>1. National Comprehensive Cancer Network. Non-Small-Cell
Lung Cancer (Version 5. 2021). http://www.nccn.org/professionals/physician_gls/pdf/nsclc.pdf</p>
110323 Surgery
CTSNet, Inc
2021
2021-11-23
2021-11-23
Media
1171987803 Bytes
10.25373/ctsnet.17064305
CC BY-NC-ND 4.0