ArticleJTCVS techniques2026
Septum-guided segmentectomy for deep early-stage non-small cell lung cancer: A novel, margin-independent, parenchyma-sparing concept.
Article in JTCVS techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Objective: The application of segmentectomy for deep-located tumors remains controversial as the result of margin concerns. This study evaluated septum-guided segmentectomy, which uses intersegmental septa and veins as anatomical boundaries to ensure precise dissection independent of fixed linear margin requirements. Methods: We retrospectively analyzed 292 patients with deep-located cT1a-bN0M0 non-small cell lung cancer undergoing septum-guided segmentectomy (n = 130) or lobectomy (n = 162) via a minimally invasive approach (January 2019 to March 2025). To rigorously control for selection bias, propensity-score matching incorporating key physiological and anatomical confounders was performed, generating 88 well-balanced matched pairs (n = 176). Perioperative outcomes, locoregional recurrence, recurrence-free survival, and overall survival were evaluated. Results: After propensity-score matching, baseline balance was achieved across key covariates. Survival analysis using stratified methods revealed no significant differences in recurrence-free survival or overall survival between the groups ( Conclusions: Septum-guided segmentectomy demonstrates preliminary oncologic safety and perioperative outcomes comparable with lobectomy for deep-located early-stage non-small cell lung cancer. By using the intersegmental septum as a reliable anatomical barrier, this concept establishes a precise surgical paradigm that safely reduces the reliance on fixed margin distances.
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