Role of segmentectomy for lung metastases from colorectal cancer: latest insights and technical developments—a review

Abstract

: Lung metastasectomy is recognized as one of the standard treatments for lung metastases from colorectal cancer (CRC) and can improve overall survival in selected patients. As a surgical procedure, wedge resection is widely preferred because it allows complete resection of the tumor and preserves lung function with low morbidity and mortality. However, several reports suggest that even when complete resection is obtained, there may be a high risk of local recurrence. Several reports have indicated an association between the frequency of recurrence and the length of the surgical margin. Segmentectomy is sometimes selected as an alternative procedure when a sufficient surgical margin cannot be obtained by wedge resection. Recently, growing evidence has revealed the benefits of segmentectomy in the field of primary lung cancer. However, in the field of lung metastasectomy, the influence of the surgical procedure on clinical outcomes has not yet been clarified. Moreover, segmentectomy is sometimes challenging for surgeons because it requires knowledge of the complex spatial bronchovascular anatomy with individual anomalies. Thus, in this review, we aim to investigate the role of lung segmentectomy in the management of lung metastases from CRC. In addition, we will review the latest surgical planning methods that help perform safe and accurate lung segmentectomies, as well as localization strategies to identify metastases in deeper regions.