title: [Videothoracoscopic anatomic pulmonary segmentary: an initial single-center experience].
abstract: The use of minimally invasive surgery for the treatment of lung cancer has been growing worldwide. Between May 2008 and November 2012, we performed 24 videothoracoscopic anatomical lung resections in our department. This includes 22 lobectomies and 2 anatomic segmentectomies, which is known to be a more complex surgery, since it demands a finer dissection of sub-lobar structures. We report the clinical cases of two patients who underwent anatomic segmentectomies. The first one was a 63 year old woman, smoker and with a history of breast cancer 20 years earlier. An incidental 9 mm node was found in the lingula. The patient underwent an anatomic lingulectomy and the frozen section was suggestive of a primary lung cancer. Therefore, we proceeded to a full lymphadenectomy. The final pathology evaluation showed a typical carcinoid tumour (pT1aN0). The second patient was a 50 year old woman, a smoker and with a heavy family history of lung cancer. In a screening CT scan a 8 mm ground glass opacity was identified in the left lower lobe (segment VI). After a VATS wedge resection of the node the frozen section evaluation was compatible with adenocarcinoma. We then proceeded to an anatomic segmentectomy with lymphadenectomy. The definitive pathology evaluation confirmed that it was a pT1a N0 bronchioloalveolar adenocarcinoma. The patients now have 5 and 2 months of follow up respectivelly and neither of them has signs of recurrence and the surgical incision showed a good aesthetic result. Anatomic segmentectomy is the indicated surgery especially in patients with low grade tumours, in early stage lung cancers or in patients without pulmonary function for a lobar resection, and it can be done safely using VATS.
authors.affiliation: Serviço de Cirurgia Cardiotorácica do Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Portugal.
authors.forename: João Eurico
authors.initials: JE
authors.lastname: Reis
authors.forename: Ivan
authors.initials: I
authors.lastname: Bravio
authors.forename: Pedro
authors.initials: P
authors.lastname: Baptista
authors.forename: Fernando Palma
authors.initials: FP
authors.lastname: Martelo
mesh_terms: D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000473:pathology / Q000601:surgery; D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011013:Pneumonectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome