Lung Segmentectomy

When is a lung segmentectomy recommended?

There are a variety of indications for a lung segmentectomy including:

Benign masses in the lung

Patients who have benign masses in the lungs may be a candidate for a lung segmentectomy.

Stage 0 non-small cell lung cancer

Most commonly, a lung segmentectomy is performed on patients with stage 0 non-small cell lung cancer. Stage 0 lung cancer is an early stage lung cancer that has not spread to the lungs. Also called carcinoma in situ, stage 0 non-small cell lung cancer affects only the few layers in one local area and has not reached the lining of the lung.

Patients who are candidates for a lung lobectomy

If you are not a candidate for a lung lobectomy, you may be a candidate for a lung segmentectomy.

Patients who don’t have satisfactory pulmonary function

If you are not able to undergo an extensive lung operation because of insufficient pulmonary function, you may be a candidate for a lung segmentectomy.

What are the risks associated with a lung segmentectomy?

Risks associated with a lung segmentectomy include:

• Pneumonia
• Infection
• Reactions to medications for anesthesia
• Breathing problems or respiratory failure
• Persistent air leakage due to injuries in the pleura
• Bleeding
• Heart attack and heart arrhythmias (irregular heart beat)

What to expect during a lung segmentectomy?

A lung segmentectomy is performed under general anesthesia (you will be asleep during the procedure) and can be performed in two ways:

Open surgery

During an open surgery lung segmentectomy, your surgeon will make an incision on the side of the affected lung, between the ribs and below the armpit area. Once in position, your surgeon will remove the diseased part of the lung.

Advanced minimally invasive surgical technique

Lung segmentectomy can now be performed minimally invasively in a surgery called a video-assisted thoracoscopic surgery (VATS). During a VATS procedure, your surgeon will make three small incisions into the chest. He or she will insert an instrument called a thoracoscopy with a camera on the end into the chest. Using surgical instruments inserted in the other incisions, your surgeon will expose the diseased lung and collapse it. The diseased portion of the lung is then removed, the excess fluid and air is drained, and the lung is re-inflated. After the lung is inflated, your surgeon will close the incision.

When appropriate, a VATS procedure is the preferred treatment due to the decreased risk for infection, shorter hospital stay and lower risk of pain.

Recovery from a lung segmentectomy

After a lung segmentectomy, you will need to stay in the hospital to recover for five to seven days if you have open surgery and two to three if you have a VATS surgery. You will be closely monitored by your doctor and cancer care team to ensure you are recovering. Upon discharge, your doctor will provide detailed instructions on:

• Physical activity level — do not drive for a week or perform and strenuous activity
• Breathing exercises
• Diet
• Wound care
• When to schedule a follow-up visit

Many patients undergo radiation therapy four to six weeks after surgery. The radiation therapy can last four to five weeks.