segmentectomy
Meaning of segmentectomy: Removal of one anatomical unit of an organ along its own blood supply, so the cut runs where nature already divided it.
Definition of segmentectomy
A segmentectomy is an operation that removes one anatomical segment of an organ, together with the artery, vein and airway or duct serving only that segment. The lung and the liver are the usual sites, since both are built from segments with separate supplies. Cutting along those natural planes leaves the remainder of the organ intact and working.
What is a segment?
A self-contained block of an organ with its own supply lines. Each lobe of the lung divides into segments, and every segment receives one branch of the airway and one branch of the artery, with its drainage running in the tissue planes between neighbors. The liver is organized the same way around branches of its portal vein. Because those boundaries are real rather than drawn for convenience, a surgeon can tie off the vessels to one segment and watch the tissue it feeds change color, which marks out exactly where to cut.
How does it compare with the neighboring operations?
| Operation | What is removed | Follows anatomy |
|---|---|---|
| Wedge | A block of tissue containing the lesion | No |
| Segmentectomy | One segment with its own supply | Yes |
| Lobectomy | A whole lobe, made of several segments | Yes |
| Pneumonectomy | The entire lung on one side | Yes |
Segmental resection is the same operation under a different name. The comparison that matters is with the wedge, which crosses the internal boundaries, takes no account of them, and therefore removes no predictable set of lymph nodes.
Why is it used in lung cancer?
For small tumors sitting near the outer edge of the lung, taking a segment instead of a whole lobe leaves more breathing capacity, which counts most for people whose lungs are already damaged or who may face further surgery later. Because the operation follows the anatomy, the lymph nodes belonging to that segment come out with it and can be examined, which a wedge cannot offer. Trials comparing it against removal of a whole lobe in small early tumors have supported its use in selected cases, so it has shifted from a compromise for the frail toward a considered choice in lung cancer surgery. Size, position and the healthy tissue lying around the tumor decide whether the smaller resection is suitable.
Also known as
Used in a sentence
A segmentectomy of the lingula was performed for the small peripheral tumor.
Good to know
A segmentectomy follows the internal anatomy and brings out the lymph nodes belonging to that segment, which separates it from a wedge resection that crosses those boundaries and samples no nodes.
Word origin
Where “segmentectomy” comes from
Segment comes from the Latin segmentum, a piece cut off, and the ending -ectomy from the Greek ektome, a cutting out.