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Journal of Cardiothoracic Surgery

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Open Access 01-12-2021 | Bronchoscopy | Case report

Lung segmentectomy assisted by highly selective independent segmental ventilation: a series of three cases

Authors: Xiaoshun Shi, Jing Ye, Junyong Chen, Jianxue Zhai, Xiguang Liu, Di Lu, Zishi Lin, Zhen Ni, Hua Wu, Kaican Cai

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

The identification of targeted intersegmental planes and resection with adequate surgical margins are among the crucial steps in anatomical pulmonary segmentectomy, and technical improvements are still needed.

Case presentation

We reported three cases of intersegmental plane identification using highly selective independent segmental ventilation during segmentectomy. All cases required cooperation with an anesthesiologist who was able to perform segmental ventilation and double confirmation of segmental bronchus branches by the surgeon. The surgical procedure provides a direct visualization of spare segment inflation and saves time in deflation over the conventional residual segment inflation method.

Conclusions

Highly selective independent segmental ventilation could be considered a suitable option for pulmonary intersegmental plane identification and could be universally used for lung segmentectomy.

Sekine Y, Ko E, Oishi H, Miwa M. A simple and effective technique for identification of intersegmental planes by infrared thoracoscopy after transbronchial injection of indocyanine green. J Thorac Cardiovasc Surg. 2012;143(6):1330–5. https://doi.org/10.1016/j.jtcvs.2012.01.079.CrossRefPubMed

Zhang Z, Liao Y, Ai B, Liu C. Methylene blue staining: a new technique for identifying intersegmental planes in anatomic segmentectomy. Ann Thorac Surg. 2015;99(1):238–42. https://doi.org/10.1016/j.athoracsur.2014.07.071.CrossRefPubMed

Misaki N, Chang SS, Igai H, Tarumi S, Gotoh M, Yokomise H. New clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system. J Thorac Cardiovasc Surg. 2010;140(4):752–6. https://doi.org/10.1016/j.jtcvs.2010.07.020.CrossRefPubMed

Churchill ED, Belsey R. Segmental Pneumonectomy in bronchiectasis: the Lingula segment of the left upper lobe. Ann Surg. 1939;109(4):481–99. https://doi.org/10.1097/00000658-193904000-00001.CrossRefPubMedPubMedCentral

Matsuoka H, Nishio W, Sakamoto T, Harada H, Yoshimura M, Tsubota N. Selective segmental jet injection to distinguish the intersegmental plane using jet ventilation. Jpn J Thorac Cardiovasc Surg. 2003;51(8):400–1. https://doi.org/10.1007/BF02719478.CrossRefPubMed

Kamiyoshihara M, Kakegawa S, Morishita Y. Convenient and improved method to distinguish the intersegmental plane in pulmonary segmentectomy using a butterfly needle. Ann Thorac Surg. 2007;83(5):1913–4. https://doi.org/10.1016/j.athoracsur.2006.06.052.CrossRefPubMed

Wang J, Xu X, Wen W, Wu W, Zhu Q, Chen L. Modified method for distinguishing the intersegmental border for lung segmentectomy. Thorac Cancer. 2018;9(2):330–3. https://doi.org/10.1111/1759-7714.12540.CrossRefPubMed

Otsuka T, Nakamura Y, Harada A, Sato M. Extremely rare but potential complication of diffuse brain edema due to air embolism during lung segmentectomy with selected segmental inflation technique by syringe needle during video-assisted thoracoscopic surgery. J Thorac Cardiovasc Surg. 2011;142(5):e151–2. https://doi.org/10.1016/j.jtcvs.2011.07.061.CrossRefPubMed

Knoll H, Ziegeler S, Schreiber JU, Buchinger H, Bialas P, Semyonov K, et al. Airway injuries after one-lung ventilation: a comparison between double-lumen tube and endobronchial blocker: a randomized, prospective, controlled trial. Anesthesiology. 2006;105(3):471–7. https://doi.org/10.1097/00000542-200609000-00009.CrossRefPubMed

10.

Amar D, Desiderio DP, Bains MS, Wilson RS. A novel method of one-lung isolation using a double endobronchial blocker technique. Anesthesiology. 2001;95(6):1528–30. https://doi.org/10.1097/00000542-200112000-00039.CrossRefPubMed

11.

Liu L, Che G, Pu Q, Ma L, Wu Y, Kan Q, et al. A new concept of endoscopic lung cancer resection: single-direction thoracoscopic lobectomy. Surg Oncol. 2010;19(2):e71–7. https://doi.org/10.1016/j.suronc.2009.04.005.CrossRefPubMed

12.

Liu C, Guo C, Lin F, Li C, Pu Q, Ma L, et al. Long term outcomes of patients with stage I lung cancer treated by single-direction video-assisted thoracoscopic surgery lobectomy or segmentectomy. Zhonghua Wai Ke Za Zhi. 2015;53(10):742–6.PubMed

13.

Cai K, Wu H, Ren P, Cai R, Xiong G, Wang H. Unidirectionally progressive resection of lower right lung cancer under video-assisted thoracoscopy. J Thorac Dis. 2013;5(Suppl 3):S310–4.PubMedPubMedCentral

14.

Liu C, Liao H, Guo C, Pu Q, Mei J, Liu L. Single-direction thoracoscopic basal segmentectomy. J Thorac Cardiovasc Surg. 2020;160(6):1586–94. https://doi.org/10.1016/j.jtcvs.2020.01.028.CrossRefPubMed

15.

Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K, Tsubota N. Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg. 2006;132(4):769–75. https://doi.org/10.1016/j.jtcvs.2006.02.063.CrossRefPubMed

16.

Oh S, Suzuki K, Miyasaka Y, Matsunaga T, Tsushima Y, Takamochi K. New technique for lung segmentectomy using indocyanine green injection. Ann Thorac Surg. 2013;95(6):2188–90. https://doi.org/10.1016/j.athoracsur.2012.12.068.CrossRefPubMed

Title: Lung segmentectomy assisted by highly selective independent segmental ventilation: a series of three cases
Authors: Xiaoshun Shi
Jing Ye
Junyong Chen
Jianxue Zhai
Xiguang Liu
Di Lu
Zishi Lin
Zhen Ni
Hua Wu
Kaican Cai
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Bronchoscopy
Thoracoscopy
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01474-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Lung segmentectomy assisted by highly selective independent segmental ventilation: a series of three cases

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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