ANATOMIC SEGMENTAL RESECTION OF THE LUNG BY THORACOSCOPY - AN EXPERIMENTAL-STUDY

In patients who are unable to undergo a lobectomy for a small peripher al lung cancer, a partial thoracoscopic resection appears to be one vi able alternative. However, since the regional lymphatics are disrupted in an anatomical fashion with a segmentectomy, it appears superior to a wedge resection. This experimental study was conducted to determine whether or not an anatomical segmental resection is feasible by thora coscopy, A segmental resection of porcine lungs was performed using th oracoscopy. The segmental vessels were divided between ligatures. The segmental bronchus was divided by an endoscopic stapler. The intersegm ental lung parenchyma was divided using a cotton dissector and a conta ct neodymium-yttrium aluminum garnet laser. Forty-three pigs were divi ded into seven groups as follows, Group 1: S1+2; group 2: S-3; group 3 : upper division; group 4: lower division; group 5: S-6; group 6: S-8; and group 7: S9+10. The operating times ranged from 145 +/- 15 min to 191 +/- 47 min. Blood loss ranged from 36 +/- 35 ml to 151 +/- 48 ml in all groups, The blood loss in the group with a resection of S-6 and S9+10 was significantly greater than that of the other five groups, M ost of the blood loss occurred during the division between the interse gmental planes. In conclusion, a thoracoscopic segmentectomy is consid ered to be technically feasible; however, further refinements in this technique are warranted before beginning clinical trials.