Videoassistierte thorakoskopische (VATS) sublobäre anatomische Resektionen beim Lungenkarzinom

Zusammenfassung

Als anatomische Segmentresektion wird die chirurgische Entfernung eines oder mehrerer bronchopulmonaler Segmente unter individueller Versorgung der entsprechenden bronchovaskulären Strukturen bezeichnet. Neben benignen Erkrankungen und unklaren Rundherden kann eine anatomische Segmentresektion bei prä- bzw. minimalinvasiven Adenokarzinomen sowie beim invasiven Frühkarzinom (T1a) indiziert sein. Die videoassistierte thorakoskopische (VATS) Technik der anatomischen Segmentresektion unterscheidet sich in wenigen Punkten von der konventionellen Methode. Sie ist technisch anspruchsvoll, verbindet aber minimale Invasivität mit maximalem Parenchymerhalt. Dadurch kann die videoassistierte thorakoskopische anatomische Segmentresektion für lungenfunktionell stark eingeschränkte, polymorbide Patienten mit NSCLC eine chirurgische Therapieoption darstellen. Ihr onkologischer Stellenwert ist anhand der verfügbaren Datenlage jedoch noch nicht endgültig beurteilbar.

Abstract

Pulmonary segmentectomy implies the removal of one or more anatomic units of the lung. It requires dissection of the segmental bronchus and artery and identification of the intersegmental vein, which should be respected. Benign lesions, solitary pulmonary nodules, pulmonary adenocarcinoma in situ and T1a lung cancer are possible indications. The VATS approach for segmentectomies is technically challenging and differs slightly from the conventional open one. Its combination of minimal invasiveness with a maximum of lung parenchyma preservation provides a surgical treatment option for NSCLC patients with little pulmonary reserve. Data on the oncologic outcome after VATS segmentectomy are inconclusive as yet.

Schlüsselwörter

Segmentresektion - videoassistierte Thorakoskopie (VATS) - Bronchialkarzinom

Key words

segmentectomy - video-assisted thoracoscopy (VATS) - lung cancer

• Literatur

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