胸腔鏡下複合亜区域切除術の検討

The Outcome of Video Assisted Thoracoscopic Combined Subsegmentectomy

近年，画像診断の進歩と胸腔鏡下手術の普及により，比較的小さなサイズの肺腫瘍が診療対象となる機会が増えている．それに伴い，早期肺癌に対する縮小手術の議論が活発になされ1，2），とりわけ本邦ではJCOG0802/WJOG4607LやJCOG0804/WJOG4507Lに代表される大規模臨床試験も実施されてきた．一方で，組織浸潤性が低いと推定される病変でも，局在位置や切除縁の観点から，区域切除術または楔状切除術では十分な腫瘍制御効果が期待できない病変も少なからず存在する．今回当科で複合亜区域切除術を行った経験症例をまとめて報告する．

Purpose：This study aimed to examine retrospectively the outcome of patients undergoing subsegmentectomy for malignant lung tumor.

Patients and Method：From 2011 to 2017, 11 patients were enrolled. We analyzed the clinicopathologic data, radiological tumor findings, and postoperative morbidity. Overall survival of primary lung cancer was also assessed.

Results：Nine patients with primary lung cancer and 2 patients with metastatic lung cancer were diagnosed. There were no serious postoperative complications. All patients had negative surgical margins and were free from local recurrence. Lung adenocarcinoma was confirmed in 9 patients, who all had early stage and 5-year overall survival rate was 89％.

Conclusions：Combined subsegmentectomy leads good results for small malignant lung tumor with tolerable complications.