ABSTRACT
Segmentectomy was first performed in 1939 for the treatment of benign pulmonary diseases such as bronchiectasis and tuberculosis. Shortly thereafter, anatomic pulmonary segmentectomy was also employed for primary lung cancers. Pulmonary segmentectomy is often indicated for benign lesions such as those caused by infectious diseases, and may also be used selectively in patients with non-small-cell lung cancer (NSCLC). Segmentectomy can be performed thorough standard lateral thoracotomy or via a VATS approach. Compared with thoracoscopic lobectomy, VATS has been applied to anatomic segmentectomy only recently. During segmentectomy, the segmental pulmonary veins, arteries, and bronchus are dissected and stapled separately. Thoracoscopic segmentectomy usually begins with identification and dissection of the segmental vein. In performing posterior segmentectomy, related branches of pulmonary artery and vein can be exposed and divided in the major fissure when opened. Alternatively, the bronchus to this segment can be tracked along the right upper lobe bronchus posteriorly and distally, dissected first, and divided.
