Complex segmentectomy for non-palpable small lung cancer adjacent to the incomplete interlobar fissure using radiofrequency identification.

Abstract

Pulmonary segmentectomy for small non-palpable tumors, such as lung cancer or pulmonary metastasis, is challenging owing to possible insufficient surgical margins. Particularly, extensive segmentectomy beyond the second lobe may be required to obtain a sufficient surgical margin for a tumor adjacent to an incomplete interlobar fissure. Radiofrequency identification (RFID) marking systems have proven beneficial for detecting small lung tumors during surgery. Herein, we present two representative cases of complex segmentectomy (left-side video-assisted thoracoscopic extended S⁸ + S⁹ segmentectomy and left-side robot-assisted thoracoscopic extended S¹⁺² b + c segmentectomy) for small lung cancer adjacent to an incomplete interlobar fissure. Extensive segmentectomy was avoided, and preservation of lung parenchyma was feasible using an RFID system. The patients could undergo segmentectomy safely with a sufficient surgical margin. In conclusion, an RFID system facilitates secure and safe precise segmentectomy while minimizing the resected pulmonary volume.