Thoracoscopic segmentectomy for trans-fissure ground-glass opacity.

Abstract

The trans-fissure ground-glass opacity is a special category of lesions, with a diameter always exceeding 2 cm. It is located on a fused fissure, "seizing" two neighboring lobes simultaneously. The segmentectomy for the trans-fissure ground-glass opacity is never reported. Between August 2016 and December 2022, patients operated with a trans-fissure ground-glass opacity were included. The patients' backgrounds and surgical data were summarized. All procedures were performed with the help of preoperative three-dimensional computed tomography bronchography and angiography. A total of 84 patients were included. The selection criteria included a consolidation tumour ratio＜50%, and a lesion size >2cm and ≤3 cm. 36 patients were operated with lobectomy+wedge (the traditional method group) and 48 patients were operated with anatomical segmentectomy+function-preserving sublobectomy (the new method group). The median operative time was 87 min in the traditional group and 98 min in the new method group, and median blood loss was 60 ml in the traditional group and 70 ml in the new method group. The median duration of hospital stays was 4 days in the traditional group and 2 days in the new method group. In the traditional method group, there was one case of postoperative air leakage and 5 cases of haemoptysis. In the new method group, two cases of postoperative air leakage were identified. The median size of the tumour in the resected segment was 2.6 cm in the traditional group and 2.5 cm in the new method group. The median margin was 2.5 cm in the traditional group and 3.3 cm in the new method group. The trans-fissure ground-glass opacity could be safely resected en-bloc by segmentectomy with a well-designed surgical procedure and appropriate preoperative planning.