title: Use of multi-detector row angiography for the arrangement of video-assisted modified segmental resection.
abstract: BACKGROUND
  Video-assisted modified segmentectomy is segmental resection using an end-stapler without regards to anatomical broncho-segmental planes. This procedure is effective for deep pulmonary lesions, and preserves pulmonary function better as compared to lobectomy. However, the biggest disadvantage of this approach is the inability to manually palpate the lung. It is difficult to determine the staple line for pulmonary division during surgery as the tumour is located near the border of the burdened segments. This study evaluated whether multi-detector row computed tomographic angiography could contribute to the preoperative arrangement of video-assisted modified segmentectomy.
  
  
  METHODS
  Video-assisted modified segmentectomy was planned for nine patients with deep pulmonary tumours measuring 3 cm or smaller (Clinical T1N0M0 lung cancer, n=4; metastatic lung tumour, n=4 and undiagnosed lesions suspicious for lung cancer, n=1). All patients underwent contrast-enhanced multi-detector row computed tomography preoperatively to determine the vessels that were to be detached and the line for dividing the pulmonary parenchyma.
  
  
  RESULTS
  All the lesions were resected with safe surgical margins under video view in keeping with the preoperative plan.
  
  
  CONCLUSIONS
  Our experience suggests that multi-detector row computed tomographic angiography provides information for determining the division of the pulmonary vessels and lung parenchyma in video-assisted segmentectomy.
authors.affiliation: Department of Thoracic Surgery, Tokai University Hachioji Hospital, 1838 Isikawa, Hachioji, Tokyo 192-0032, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamada
authors.forename: Atushi
authors.initials: A
authors.lastname: Suga
authors.forename: Yosimasa
authors.initials: Y
authors.lastname: Inoue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D017792:Surgical Stapling / Q000379:methods; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods