Clinical outcome and risk factors for complications after pulmonary segmentectomy by video-assisted thoracoscopic surgery: results of an initial experience

Pulmonary anatomical segmentectomy is a parenchyma-sparing technique that is increasingly proposed for benign lesions, metastases, or for patients with non-small cell lung cancer (NSCLC) who cannot tolerate lobectomy. Segmentectomies can be technically challenging, but are being proposed more frequently through the use of video-assisted thoracoscopic surgery (VATS). Moreover, for early stage NSCLC, pulmonary segmentectomy has shown promising results and is currently considered safe for early stage tumors <2 cm in an appropriate location and with sufficient resection margins (1-5). So far, despite its attractiveness, VATS segmentectomy remains technically arduous. Furthermore, although the impact of surgeon volume on outcomes for lung surgery by VATS is significant (6-7), the impact of surgeon volume on outcomes after pulmonary segmentectomy specifically is not known. Therefore, we undertook a cohort study to analyze the clinical outcomes and identify risk factors for post-operative complications after pulmonary segmentectomy by VATS was introduced in two university hospitals