- What Is
What are lung segmentectomy and limited pulmonary resection?
A lung segmentectomy is a procedure to remove the diseased lung without removing excess normal lung.
Certain diseases, such as lung cancer, may require removal of the part of the lungs to limit the spread of cancer in the body. The surgery that removes a lung or part of the lungs is called a pulmonary resection. In some forms of pulmonary resection, most of the lung tissue is salvaged and only a wedge or segment (lung segmentectomy) of the lungs is removed. Such a surgery is called a limited pulmonary resection.
The lungs are divided into segments based upon certain anatomical criteria such as different blood supply. In a segmentectomy, these anatomic criteria are considered for resection in a lung segment. In a wedge resection, however, a non-anatomic lung resection is done to remove a wedge of the lung.
Removing a small diseased portion of the lungs is effective because it preserves most of the functional lungs. However, it is only possible when the disease is confined to a small part of the lungs. Because the technique is technically demanding, some surgeons may prefer to wedge out the lung lesion (wedge resection) using a stapler. The recurrence rate of cancer after a wedge resection, however, is higher than that after a segmentectomy.
Although a lung segmentectomy has been popular for the resection of infected lesions and non-cancerous masses, some experts have also recommended it for very early lung cancer.
The choice for patients with lung cancer is usually a lobectomy (surgical removal of a lobe of the lung), but in some patients with diseased lungs having a minimal lung reserve, a lung segmentectomy is a good option. Limited pulmonary resection and segmentectomy are also used to treat various lung infections and birth defects (congenital lung malformations).
Both segmentectomy and lesser lung resection can be performed via open surgery (thoracotomy) or a small incision surgery (video-assisted thoracoscopic surgery or VATS) that yields better outcomes, less pain, and shorter recovery than the traditional techniques.
In which cases are lung segmentectomy and limited pulmonary resection done?
Lung segmentectomy and limited pulmonary resection are performed in the following cases:
What are the major complications of lung segmentectomy and limited pulmonary resection?
Three major complications that can occur during the surgery are massive bleeding due to an injury to the pulmonary artery (the blood vessel that supplies the lungs) or its branches, abnormal heart rhythm, and pneumothorax in the contralateral lung (the presence of air or gas in the cavity between the contralateral lung and chest wall, causing the collapse of the lung).
The most common complications of lung segmentectomy and limited pulmonary resection include the following:
- Air leakage: Most leaks seal within a few days, but large leaks may persist for weeks
- Residual airspace can occur when a large amount of lung is resected
- Infection of the pleural space (the space between the lung and its covering or pleura) can occur when residual airspace persists; in some cases, the patient may require another surgery to close off the residual space and eliminate the infection.
- Respiratory failure is not a direct complication of surgery; patients who have borderline lung function are more likely to develop respiratory distress in the postoperative period.
- Cardiac complications may include heart attack (myocardial infarction) and arrhythmias (abnormal heart rhythm)
Health Solutions From Our Sponsors
Medscape Medical Reference
Top Lung Segmentectomy Limited Pulmonary Resection Related Articles
What Is Bronchiectasis?Bronchiectasis has three types: cylindrical bronchiectasis, saccular or varicose bronchiectasis, and cystic bronchiectasis. Causes of bronchiectasis include infection, environmental exposure, drug or alcohol abuse, and alpha-1 antitrypsin (congenital). Symptoms of bronchiectasis include shortness of breath, fatigue, chronic cough, bloody sputum, and wheezing. Treatment for bronchiectasis includes antibiotics and possibly surgery.
Is Tuberculosis (TB) Contagious?Mycobacterium tuberculosis causes tuberculosis (TB). TB may be transmitted when an infected person sings, sneezes, coughs, or talks. TB symptoms and signs include coughing bloody sputum, night sweats, severe cough, fever, chills, fatigue, and weight loss.
Lung CancerLung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due to tobacco smoke. Lung cancers are classified as either small-cell or non-small-cell lung cancers.
Lung Cancer Myths/FactsLearn about lung cancer myths and facts. Explore how cigar smoke, menthol, and pollution can increase your risk of lung cancer and learn what to avoid.
Lung Cancer PictureCancer of the lung, like all cancers, results from an abnormality in the body's basic unit of life, the cell. See a picture of Lung Cancer and learn more about the health topic.
Lung Cancer SlideshowLearn about lung cancer early warning signs, symptoms and treatments. What causes stage IV lung cancer? Get more information on small cell lung cancer, non-small cell lung cancer, and the diagnosis of lung cancer stages.
Know Your Lung Cancer Facts QuizLung cancer is the number one cause of cancer deaths in both men and women in the U.S. and worldwide. Get the facts about lung cancer with this quiz.
Small Cell Lung Cancer vs. Non-Small Cell Lung CancerNon-small cell lung cancers (NSCLC) consist of large cell carcinomas, adenocarcinomas, and squamous cell carcinomas. Small cell lung cancer (SCLC) usually starts in the bronchi and typically appears in those who smoke. SCLC and NSCLC are staged in different manners, and SCLC tends to metastasize more quickly than NSCLC. Signs and symptoms of NSCLC and SCLC include shortness of breath, coughing up blood, recurring lung infections, and chest pain. Treatment may involve radiation therapy, chemotherapy, and surgery.
Tuberculosis (TB)Mycobacterium tuberculosis is the bacterium that causes tuberculosis (TB). Symptoms and signs of TB include bloody sputum, fever, cough, weight loss, and chest pain. Treatment depends upon the type of TB infection.
Tuberculosis Skin Test (PPD Skin Test)The tuberculosis skin test is based on the fact that infection with M. tuberculosis produces a delayed-type hypersensitivity skin reaction to certain components of the bacterium. The standard recommended tuberculin test is administered by injecting 0.1mL of 5 TU (tuberculin units) PPD into the top layers of skin of the forearm. "Reading" the skin test means detecting a raised, thickened local area of skin reaction, referred to as induration. The area of induration (palpable, raised, hardened area) around the site of injection is the reaction to tuberculin.
What Are the Main Types of Thoracic Incisions?A thoracic incision is a surgical cut made on the chest (thorax) to get access to the space between the lungs and chest wall. Thoracic incisions are performed in patients undergoing surgeries for conditions, such as lung cancer, noncancerous lung masses, disorders of the heart, aortic aneurysm (ballooning or bulging of the aorta at certain weak areas in its wall), aortic dissection/transection (tears in or rupture of the aorta), tumors in the spine, tumors in the esophagus, and chest injuries.
What Is Endotracheal Intubation Used For?Endotracheal intubation is the procedure to insert a flexible tube into the airway (trachea) through the mouth or the nose. The endotracheal tube is most often placed through the mouth, especially in emergencies. Endotracheal intubation is usually performed prior to surgeries with general anesthesia or in patients under critical care.
What Is the Life Expectancy of Someone With COPD?Chronic obstructive pulmonary disease (COPD) is a group of diseases with the chief symptom of breathlessness and cough. COPD is a slowly progressive disease. Depending on the disease severity, the five-year life expectancy for people with chronic obstructive pulmonary disease (COPD) ranges from 40%-70%. That means 40-70 out of 100 people will be alive after five years of diagnosis of COPD.
What Is Thoracoscopic Wedge Resection?Thoracoscopic wedge resection is a minimally invasive surgical procedure that involves a small surgical cut (incision) for the removal of a small, wedge-shaped piece of the lung tissue. This surgery is used for removing a small tumor or to diagnose lung conditions. Thoracoscopic wedge resection involves a small incision and is safer than conventional open surgery.