Segmental Lung Resection

Lung cancer is the second most common cancer in men and women in the United States and the leading cause of cancer death. One of the primary treatment approaches for lung cancer is removing all or part of the diseased lung. The earliest lung surgery approaches were limited by the complexity of operating on the lungs without general anesthesia as we know it today. This often resulted in the resection of more healthy tissue than may be necessary. The initial approach involved the removal of an entire lung, the pneumonectomy. As the morbidity and mortality of pneumonectomies became clear, the research ended in less radical procedures. In 1962 Shimkin showed that lobectomy, or removing a single lobe of the lung, was equal to pneumonectomy in survival and carried lower morbidity. This led to the current paradigm wherein lobectomy is the gold standard for lung cancer resection.The North American Lung Cancer Study Group (LCSG) released a prospective randomized study in 1995 that demonstrated increased recurrence and worse outcomes with sublobar resection than lobectomy in lung cancer. Due to this result, segmentectomy is currently limited to patients that cannot undergo lobectomy. Multiple studies have been conducted to compare lobectomy and segmentectomy, incorporating thoracic surgery advancement since the LCSG study. Jensik first described resection of the anatomic lung segment in 1973. There is ongoing interest in sublobar resection for lung cancer, although currently, indications remain limited.