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International Society For Minimally Invasive Cardiothoracic Surgery

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Uniportal VATS Right Bonchoplastic Segmentectomy 7
Ahmed Ahmed, MD1, Ibrahem Albalkhi2, Hamsa Aldebakey2, Joud Jafar Momani2, Norah Albugami2, Lara Jaber Alnaqaeb2, Tahirah Abdullah Alhaider2, Mohamed Hussein, MD1, Nasser Alsheriff, MD1, Hazem Albeyali, MD1, Mahmoud Hashim, MD1, Norberto Santana-Rodríguez, MD, PhD, FEBTS1.
1King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, 2Alfaisal University, Riyadh, Saudi Arabia.

BACKGROUND: Uniportal complex segmentectomies are complex. There few cases of segmentectomies 7 or bronchoplastic segmentectomies reported. Segmentectomies for carcinoid tumors could be challenging due to the central location and tumor size, but when feasible, it is helpful to preserve pulmonary function significantly.
OBJECTIVE: To describe for the first time a uniportal VATS right bronchoplastic segmentectomy 7.
METHODS: A 32-year-old male nonsmoker presented with chest pain, progressive hemoptysis, and shortness of breath for 2 years. CT chest showed two synchronous lung nodules, one located in the left superior and anterior segments and another one in the right segment 7 with significant uptake in the gallium PET scan. Bronchoscope showed a carcinoid tumor involving the right carina between segments 7&8 and the entrance of the left superior segment. FEV1(L) was 3.87. The patient underwent uniportal VATS left bronchoplastic lower lobectomy and posteriorly uniportal bronchoplastic right segmentectomy 7 extended to segment 8. The operative time, pain scale (0-10), estimated blood loss, complications, length hospital stay, surgical margins, and lymph nodes involvement were assessed.
RESULTS: The operative time was 91 min, and the estimated blood loss was 100 ml. The average pain was 1,3. R0 resection was achieved, and the pathology revealed the presence of a 2.5x1.8 cm typical carcinoid tumor without lymph node involvement. The patient was discharged on the first operative day without complications.
CONCLUSIONS: Uniportal right bronchoplastic segmentectomy 7 for central carcinoid tumors is feasible and an excellent procedure to preserve lung function overall in young patients or patients with synchronous carcinoid tumors located in basal segments.


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