Technical Advances in Segmentectomy for Lung Cancer: A Minimally Invasive Strategy for Deep, Small, and Impalpable Tumors.
Takashi EguchiToshihiko SatoKimihiro ShimizuPublished in: Cancers (2021)
With the increased detection of early-stage lung cancer and the technical advancement of minimally invasive surgery (MIS) in the field of thoracic surgery, lung segmentectomy using MIS, including video- and robot-assisted thoracic surgery, has been widely adopted. However, lung segmentectomy can be technically challenging for thoracic surgeons due to (1) complex segmental and subsegmental anatomy with frequent anomalies, and (2) difficulty in localizing deep, small, and impalpable tumors, leading to difficulty in obtaining adequate margins. In this review, we summarize the published evidence and discuss key issues related to MIS segmentectomy, focusing on preoperative planning/simulation and intraoperative tumor localization. We also demonstrate two of our techniques: (1) three-dimensional computed tomography (3DCT)-based resection planning using a novel 3DCT processing software, and (2) tumor localization using a novel radiofrequency identification technology.
Keyphrases
- thoracic surgery
- robot assisted
- minimally invasive
- early stage
- computed tomography
- patients undergoing
- magnetic resonance imaging
- spinal cord
- systematic review
- squamous cell carcinoma
- radiation therapy
- data analysis
- magnetic resonance
- loop mediated isothermal amplification
- sentinel lymph node
- spinal cord injury
- contrast enhanced
- lymph node
- meta analyses