Segmentectomy lung (segmental resection) - surgery to remove the lung segment. This type of surgery is used in cases where the cancer is in an early stage, and tumor cells occupy a small area. After the operation, easy operation recovers quickly due to the fact that the functions of the resected begin to perform the rest of the departments.
Selection of treating a patient with the disease depends on several factors:
- Oncology step (where the tumor, if cancer cells have spread to other parts of the body).
- Type of cancer.
- Size malignancy.
- Symptoms of the disease.
- The general health of the patient.
When the size of the cavities is from 1 to 2 cm, often conducted wedge resection of the lung , but it is more dangerous than holding segmentectomy as during surgery damaged the bronchi, and doctors harder to take in the wound in the lung.
Indications and contraindications for segmentectomy and wedge resection of the lung
The main indications for lung wedge resection and segmentectomy are:
- lung cancer at an early stage;
- pulmonary nodes;
- abscessed pneumonia.
- diffuse lung disease;
- bleeding disorders - coagulopathy;
- preoperative skin disease in the body portion;
- multiple metastases.
Diagnosis and preparation for surgery
Specialists clinic Assuta in Israel carried out a complete diagnosis of the patient before surgery. The obtained results of analyzes and help determine whether cancer cells have spread from the lung to other parts of the body after it has been diagnosed.
To determine the stage of cancer the patient passes a full medical examination, as well as the clinic doctors are studying its history and medical history of the family members. Next, do chest X-ray, computed tomography, positron emission tomography, taken blood tests, tissue and urine. Performed bronchoscopy, mediastinoscopy, biopsy of the lymph nodes. Treatment is possible only when the stage of the cancer has been identified.
The day before surgery, after dinner, the patient should stop taking food and liquid. Clinic doctors instruct the patient describe the possible risks and expected results after segmentectomy easy .
The methodology of the lung segmentectomy
Surgery may be done in two ways:
1.Videotoraskopicheskaya surgery (VATS). Removing the light segment is carried out not at the opening of the chest, and through small punctures. To do this, Assuta Hospital, doctors use a special endoscopic instrument. Surgical technique itself is not much different from the traditional, but holding segmentectomy VATS method has a number of significant advantages:
- more rapid rehabilitation of the patient;
- the absence of large scars on the chest;
- postoperative pain less pronounced.
2.Otkryty method. It is carried out using thoracotomy. When VATS and thoracotomy surgery the patient is in a state of general anesthesia.
At the hospital, Assuta segmentectomy open method is performed as follows:
- Thoracotomy. Surgeons use anterolateral thoracotomy in order to gain access to the anterior or apical pulmonary segment. Posterolateral thoracotomy, usually used for the removal of one of the posterior lung segments.
- Exemption from the lung pleural adhesions. To facilitate the preparation process is carried out hydraulically.
- The doctor inserts a 0.25% solution of novocaine under the pleura at the root of the lung for its anesthesia.
- The surgeon selects a segmental bronchus and vessels after the cut folds of the pleura. Next is their ligation. Isolation of the desired pulmonary segment made blunt manner.
- The surgeon stops bleeding in the wound and performs intersection bronchus and lung vessels between ligatures.
- Produced removal of the affected segment.
- Ligature of the intersegmental veins. Bronchial stump is covered by the pleura.
- The doctor carries out washing the pleural cavity and two sets drainage tube (top and bottom drain), and then the wound is sutured.
Restoration of the patient after surgery
After segmentectomy light while patients are under the supervision of medical staff Assuta Hospital. In order to reduce post-operative pain prescribe specific medications, and if the medication is not effective, the patient visits the doctor, because the severe pain can be a symptom of postoperative complications. rehabilitation time depends on the individual characteristics and factors, and also on whether the VATS thoracotomy or during surgery operation applied. Most patients return to normal life after 8 weeks after surgery.
According to statistics, the mortality rate after segmentectomy and wedge resection of the lung in patients who have no other diseases, is about 1%. Patients with poor pulmonary reserve have a higher probability of postoperative complications. Also, for some patients it is a risk general anesthesia and the adoption of medicines. Infection of the operating area is observed in 3-4% of patients. May cause pneumonia, empyema and pleuropulmonary fistula.
Often after segmentectomy easily carried out treatment by radiotherapy , so pregnant women and other patients who, for whatever reasons, can not be exposed to ionizing radiation, chosen a different type of treatment. After surgery, radiation therapy sessions are held 4-6 weeks and continue for 4-5 weeks.