Our Summary

This paper is about a surgical method called pulmonary segmentectomy, which is used to treat early-stage lung cancer (specifically, stage I nonsmall cell lung cancer). Unlike lobectomy, which involves removing a whole lobe of the lung, segmentectomy only removes a small part of the lung. This procedure has become easier to perform thanks to advances in technology, such as robots and video-assisted surgery. Two recent studies have shown that segmentectomy can be just as effective as lobectomy for treating small lung tumors (2 cm or smaller). The paper will further discuss the use of robots in performing segmentectomy.

FAQs

  1. What is pulmonary segmentectomy and what is it used for?
  2. How does pulmonary segmentectomy differ from lobectomy?
  3. What recent technological advances have made segmentectomy easier to perform?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung surgery is to quit smoking before the surgery and to continue to refrain from smoking afterwards. Smoking can greatly hinder the healing process and increase the risk of complications after surgery. It is important to follow the doctor’s instructions carefully to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for lung surgery, specifically pulmonary segmentectomy, include those with early-stage lung cancer (stage I nonsmall cell lung cancer) who have small tumors (2 cm or smaller). Segmentectomy may be recommended for patients who are not suitable candidates for lobectomy, which involves removing a whole lobe of the lung, due to factors such as poor lung function or other medical conditions. Patients who are generally in good health and have early-stage lung cancer are good candidates for pulmonary segmentectomy. Additionally, patients who are able to undergo minimally invasive surgery, such as video-assisted surgery or robot-assisted surgery, may also be recommended for segmentectomy.

Timeline

Before lung surgery:

  1. Patient presents with symptoms, undergoes diagnostic tests (such as imaging scans and biopsies) to confirm lung cancer.
  2. Patient meets with a surgeon to discuss treatment options, including segmentectomy.
  3. Patient undergoes preoperative evaluations and tests to ensure they are healthy enough for surgery.
  4. Patient receives instructions on preoperative care, such as fasting before surgery and stopping certain medications.

During lung surgery:

  1. Patient is given anesthesia and the surgeon makes small incisions in the chest.
  2. Surgeon uses a camera and robotic instruments to remove the affected segment of the lung.
  3. Surgery typically lasts a few hours, depending on the complexity of the case.
  4. Surgeon closes the incisions and patient is taken to the recovery room.

After lung surgery:

  1. Patient is closely monitored in the hospital for a few days to ensure no complications arise.
  2. Patient may experience pain, shortness of breath, and fatigue post-surgery.
  3. Patient begins a gradual recovery process, including breathing exercises and physical therapy.
  4. Patient follows up with the surgeon for postoperative appointments and may undergo additional treatments, such as chemotherapy or radiation therapy.
  5. Patient undergoes regular follow-up scans to monitor for any signs of cancer recurrence.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pulmonary segmentectomy?

  2. How long is the recovery process after undergoing a pulmonary segmentectomy?

  3. Will I need to undergo any additional treatments, such as chemotherapy or radiation therapy, after the surgery?

  4. What are the chances of the cancer recurring after undergoing a pulmonary segmentectomy?

  5. How experienced are you in performing pulmonary segmentectomy procedures?

  6. Are there any alternative treatment options to consider besides pulmonary segmentectomy?

  7. Will I need to make any lifestyle changes or follow a specific diet after undergoing a pulmonary segmentectomy?

  8. How will my lung function be affected after undergoing a pulmonary segmentectomy?

  9. What can I expect in terms of pain management during and after the surgery?

  10. How often will I need to follow up with you for post-operative care and monitoring?

Reference

Authors: Merritt RE. Journal: Thorac Surg Clin. 2023 Feb;33(1):43-49. doi: 10.1016/j.thorsurg.2022.09.002. PMID: 36372532