VATS Right Basal Segmentectomy for a Benign Cystic Mass

A 69-year-old patient was admitted to the authors’ department for a right lower lobe mass resection. The patient had a personal history of smoking (discontinued), hypertension, and COPD. He had no symptoms, but an x-ray revealed a mass in the right lower lobe, which was confirmed with a CT scan. The mass was a 44 x 40 x 38 mm, with a cystic appearance. Bronchoscopy showed extrinsic compression of the segmental bronchi 8 and 9. The FEV1 was 54% and the DLCO 123%. Considering that the mass had a benign appearance, the authors planned a VATS right basal segmentectomy, sparing the superior segment of the lobe.

A 3-4 cm utility incision was performed anteriorly in the 5th intercostal space, while the thoracoscopic access was performed in the 8th intercostal space in the posterior axillary line. A 4 cm mass was detected in the right lower lobe, too deep and central for wedge resection. The superior segment was not affected. A basilar segmentectomy was completed. A single chest tube was inserted through the thoracoscopic access at the end of the procedure. It was removed the day after, and the patient was discharged on the second postoperative day.

The final pathological result revealed infected bronchiectases with fibroinflammatory changes.