Peripheral pure ground-glass opacity: segmentectomy versus wedge resection

Abstract

Introduction Sublobar resection has been widely accepted for treating pure ground-glass opacities (GGOs). As GGOs have good prognosis, preserving postoperative pulmonary function is the major concern in surgery. No studies have yet compared the success rates of pulmonary function reservation between segmentectomy and wedge resection. Method The three-dimensional rebuild of computed tomography (CT) images was performed, the segmentectomy and wedge resection of the GGO in the target segment were simulated, and the area of cut surface was measured, which was important data for successful postoperative pulmonary recruitment maneuvers. Result With equal volumes of tissue removed, segmentectomy and wedge resection showed similar surface area loss for RS4 and RS5, followed by LS7 + 8, LS6 and LS1 + 2 segments. Compared with other segments, wedge resection performed in RS10, LS3, LS10, RS9 and RS7 may lead to a loss of lot more surface area than segmentectomy. Conclusion Wedge resection is suggested for segments RS4, RS5, LS1 + 2 and LS7 + 8, whereas segmentectomy is advised for segments RS1, LS4 + 5 and RS2. Meanwhile, deep wedge resection should be avoided for segments RS8, RS7, RS10, LS3, LS10. RS9 and LS9, in order to preserve a larger lung surface area.

Dorsal incision shows more efficacy and safety to traditional incision in single-portal video-assisted thoracoscopic surgery segmentectomy of LS9+10: a non-randomized prospective clinical trial

“…Wedge resection is another approach for sublobectomy. Our team speculated that segmentectomy would show a greater advantage than wedge resection in LS9+10, as wedge resection of LS9+10 would induce more pulmonary surface loss and affect the expansion of residual lung tissue ( 9 ).…”