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Sublobar Resection
Allen Heeger, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Wedge resection (nonanatomic sublobar resection)
            • Segmentectomy (anatomic sublobar resection)
            • Other: Sublobectomy, sublobular, conservative, lesser, substandard, or limited
          • Definitions

            • Anatomic sublobar resection (segmentectomy): Excision of 1 or more lung segments and accompanying lymph nodes; requires dissection of corresponding artery, vein, and bronchi
              • Basilar segmentectomy: All lower lobe basilar segments
              • Lingulectomy: Lower division left upper lobectomy
              • Lingular sparing lobectomy: Upper division left upper lobectomy
            • Nonanatomic sublobar resection (wedge): Nonanatomic excision of peripheral pulmonary lesion with clear margins and without involving hilar structures

          IMAGING

          • Radiographic Findings

            • CT Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  CLINICAL ISSUES

                  • Presentation

                    • Natural History & Prognosis

                      • Treatment

                        Selected References

                        1. Chiang XH et al: Propensity-matched analysis comparing survival after sublobar resection and lobectomy for cT1N0 lung adenocarcinoma. Ann Surg Oncol. 27(3):703-15, 2020
                        2. Sato M: Precise sublobar lung resection for small pulmonary nodules: localization and beyond. Gen Thorac Cardiovasc Surg. 68(7):684-91, 2020
                        3. Eguchi T et al: Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: a propensity score-matched analysis. J Thorac Oncol. 14(1):87-98, 2019
                        4. Wu J et al: Sublobar resection compared with stereotactic body radiation therapy and ablation for early stage non-small cell lung cancer: a National Cancer Database study. J Thorac Cardiovasc Surg. 160(5):1350-7, 2019
                        5. de Groot PM et al: Postoperative imaging and complications in resection of lung cancer. Semin Ultrasound CT MR. 39(3):289-96, 2018
                        6. Subramanian M et al: Long-term results for clinical stage IA lung cancer: comparing lobectomy and sublobar resection. Ann Thorac Surg. 106(2):375-81, 2018
                        7. de Groot PM et al: Lung cancer: postoperative imaging and complications. J Thorac Imaging. 32(5):276-87, 2017
                        8. Yuan P et al: Sublobar resection for pulmonary aspergilloma: a safe alternative to lobectomy. Ann Thorac Surg. 103(6):1788-94, 2017
                        9. Bommart S et al: Normal postoperative appearances of lung cancer. Diagn Interv Imaging. 97(10):1025-35, 2016
                        10. Rotman JA et al: Postoperative complications after thoracic surgery for lung cancer. Clin Imaging. 39(5):735-49, 2015
                        11. Asamura H: Role of limited sublobar resection for early-stage lung cancer: steady progress. J Clin Oncol. 32(23):2403-4, 2014
                        12. Cao C et al: Meta-analysis of intentional sublobar resections versus lobectomy for early stage non-small cell lung cancer. Ann Cardiothorac Surg. 3(2):134-41, 2014
                        13. Fox M et al: Surgical management of pulmonary carcinoid tumors: sublobar resection versus lobectomy. Am J Surg. 205(2):200-8, 2013
                        14. Martin-Ucar AE et al: Indication for VATS sublobar resections in early lung cancer. J Thorac Dis. 5 Suppl 3:S194-9, 2013
                        15. Kanzaki R et al: Long-term results of surgical resection for pulmonary metastasis from renal cell carcinoma: a 25-year single-institution experience. Eur J Cardiothorac Surg. 39(2):167-72, 2011
                        16. Kanzaki R et al: Outcome of surgical resection for recurrent pulmonary metastasis from colorectal carcinoma. Am J Surg. 202(4):419-26, 2011
                        17. Yendamuri S et al: Is sublobar resection sufficient for carcinoid tumors? Ann Thorac Surg. 92(5):1774-8; discussion 1778-9, 2011
                        18. Kaifi JT et al: Indications and approach to surgical resection of lung metastases. J Surg Oncol. 102(2):187-95, 2010
                        19. Carballo M et al: Video-assisted thoracic surgery (VATS) as a safe alternative for the resection of pulmonary metastases: a retrospective cohort study. J Cardiothorac Surg. 4:13, 2009
                        Related Anatomy
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                        Related Differential Diagnoses
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                        References
                        Tables

                        Tables

                        KEY FACTS

                        • Terminology

                          • Imaging

                            • Top Differential Diagnoses

                              • Clinical Issues

                                TERMINOLOGY

                                • Synonyms

                                  • Wedge resection (nonanatomic sublobar resection)
                                  • Segmentectomy (anatomic sublobar resection)
                                  • Other: Sublobectomy, sublobular, conservative, lesser, substandard, or limited
                                • Definitions

                                  • Anatomic sublobar resection (segmentectomy): Excision of 1 or more lung segments and accompanying lymph nodes; requires dissection of corresponding artery, vein, and bronchi
                                    • Basilar segmentectomy: All lower lobe basilar segments
                                    • Lingulectomy: Lower division left upper lobectomy
                                    • Lingular sparing lobectomy: Upper division left upper lobectomy
                                  • Nonanatomic sublobar resection (wedge): Nonanatomic excision of peripheral pulmonary lesion with clear margins and without involving hilar structures

                                IMAGING

                                • Radiographic Findings

                                  • CT Findings

                                    • Imaging Recommendations

                                      DIFFERENTIAL DIAGNOSIS

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Natural History & Prognosis

                                            • Treatment

                                              Selected References

                                              1. Chiang XH et al: Propensity-matched analysis comparing survival after sublobar resection and lobectomy for cT1N0 lung adenocarcinoma. Ann Surg Oncol. 27(3):703-15, 2020
                                              2. Sato M: Precise sublobar lung resection for small pulmonary nodules: localization and beyond. Gen Thorac Cardiovasc Surg. 68(7):684-91, 2020
                                              3. Eguchi T et al: Lobectomy is associated with better outcomes than sublobar resection in spread through air spaces (STAS)-positive T1 lung adenocarcinoma: a propensity score-matched analysis. J Thorac Oncol. 14(1):87-98, 2019
                                              4. Wu J et al: Sublobar resection compared with stereotactic body radiation therapy and ablation for early stage non-small cell lung cancer: a National Cancer Database study. J Thorac Cardiovasc Surg. 160(5):1350-7, 2019
                                              5. de Groot PM et al: Postoperative imaging and complications in resection of lung cancer. Semin Ultrasound CT MR. 39(3):289-96, 2018
                                              6. Subramanian M et al: Long-term results for clinical stage IA lung cancer: comparing lobectomy and sublobar resection. Ann Thorac Surg. 106(2):375-81, 2018
                                              7. de Groot PM et al: Lung cancer: postoperative imaging and complications. J Thorac Imaging. 32(5):276-87, 2017
                                              8. Yuan P et al: Sublobar resection for pulmonary aspergilloma: a safe alternative to lobectomy. Ann Thorac Surg. 103(6):1788-94, 2017
                                              9. Bommart S et al: Normal postoperative appearances of lung cancer. Diagn Interv Imaging. 97(10):1025-35, 2016
                                              10. Rotman JA et al: Postoperative complications after thoracic surgery for lung cancer. Clin Imaging. 39(5):735-49, 2015
                                              11. Asamura H: Role of limited sublobar resection for early-stage lung cancer: steady progress. J Clin Oncol. 32(23):2403-4, 2014
                                              12. Cao C et al: Meta-analysis of intentional sublobar resections versus lobectomy for early stage non-small cell lung cancer. Ann Cardiothorac Surg. 3(2):134-41, 2014
                                              13. Fox M et al: Surgical management of pulmonary carcinoid tumors: sublobar resection versus lobectomy. Am J Surg. 205(2):200-8, 2013
                                              14. Martin-Ucar AE et al: Indication for VATS sublobar resections in early lung cancer. J Thorac Dis. 5 Suppl 3:S194-9, 2013
                                              15. Kanzaki R et al: Long-term results of surgical resection for pulmonary metastasis from renal cell carcinoma: a 25-year single-institution experience. Eur J Cardiothorac Surg. 39(2):167-72, 2011
                                              16. Kanzaki R et al: Outcome of surgical resection for recurrent pulmonary metastasis from colorectal carcinoma. Am J Surg. 202(4):419-26, 2011
                                              17. Yendamuri S et al: Is sublobar resection sufficient for carcinoid tumors? Ann Thorac Surg. 92(5):1774-8; discussion 1778-9, 2011
                                              18. Kaifi JT et al: Indications and approach to surgical resection of lung metastases. J Surg Oncol. 102(2):187-95, 2010
                                              19. Carballo M et al: Video-assisted thoracic surgery (VATS) as a safe alternative for the resection of pulmonary metastases: a retrospective cohort study. J Cardiothorac Surg. 4:13, 2009