To evaluate the feasibility and safety of anatomic segmentectomy with video-assisted thoracoscopic surgery(VATS).

The clinical data of 36 patients with lung diseases undergoing anatomic segmentectomy with VATS in the First Affiliated Hospital of Nanyang Medical College between January 2012 and December 2014 were retrospectively analyzed. Left lung apex posterior segmental resection(natural section) was done in 5 cases, and tongue resection in 7 cases; left lung lobe resection in 4 cases, and basal segment resection in 4 cases; right lung apex segmental resection in 3 cases, anterior resection in 2 cases, and posterior resection in 3 cases; right lung dorsal segment of lower lobe resection in 5 cases, and basal segment resection in 3 cases.

All patients completed anatomic segmentectomy, and there was no transfer to open chest surgery. The operation time ranged from 105 to 310 min, with an average of 175 min. The volume of bleeding was 30 to 210 ml, wih an average of 125 ml. The drainage volume was 160 to 1 250 ml, with an average of 350 ml. The time of drainage tube was 2 to 9 d, with an average of 4 d. The length of hospital stay was 4 to 15 d, with an average of 7 d. There was one case of thoracic cavity bleeding, one case of atrial fibrillation, one case of persistent pulmonary leak and two cases of pulmonary infection in one week after operation, and all were properly treated and discharged. The incidence of postoperative complications was 13.8% (5/36). The follow-up time ranged from 1 to 32 months, with an average of 12 months. Chest CT was reviewed 2 months after operation, and the adjacent lung segments to the resected expanded well. There was no recurrence or metastasis in 17 patients with primary lung cancer (excluding 4 cases of metastastic cancer).

Anatomic segmentectomy with VATS is safe and feasible, and can achieve a most precise and minimally invasive lesion resection.