Uniportal video-assisted thoracoscopic surgery segmentectomy

Lobectomy was considered as the standard of care for lung cancer resection since 1995. In the past decade, segmentectomy has gained increasing popularity as a good alternative for stages 1A1 and 1A2 lung cancer patients, achieving the dual goals of a curative lung cancer operation and lung function preservation. The entity of multiple primary lung cancer (MPLC) and its significance are discussed. Important preoperative, intraoperative, and postoperative considerations for segmentectomy are outlined. Three cases are discussed to illustrate key concepts. In properly selected patients, an anatomical segmentectomy with proper bronchovascular dissection and good resection margins should be performed. Full nodal dissection of N1 and N2 lymph nodes must be performed in order to ascertain full pathological staging to guide further treatment. Uniportal video-assisted thoracoscopic surgery (UVATS) segmentectomy can be performed on all lung segments, and allows for full and early functional recovery.