What Is a Segmental Resection?

A segmental resection removes a part of a gland, organ, or other structure in the body, often because of concerns about cancer. This procedure conserves tissue, which can be desired in a number of cases, but it can come with some risks. It is commonly used in breast cancer treatment and management of lung tumors, although it can be considered for other procedures as well. If a surgeon feels segmental resection is appropriate, it is important to be aware that circumstances during surgery may necessitate a change to the plan.

In this approach, a surgeon identifies the area to be removed before the surgery, concentrating on a tumor and the surrounding tissue, or an area of questionable tissue. During the procedure, the surgeon carefully cuts out the segment, like part of the lobe of a lung, or a breast tumor and the material around it. This tissue can be examined in the operating room for more information in addition to being sent to pathology for evaluation.

Tissue preservation can be valuable because it may conserve organ function or shape. In breast cancer cases, for example, a segmental resection removes only part of the breast, instead of all the tissue. This can make patients more comfortable and may make reconstructive surgery easier in the future, if it is desired. One risk is that it may mean dangerous tissue is left behind during the procedure, and a cancer could recur.

Another concern with segmental resection is that it can result in a large surface area of exposure at the surgical site. With the lung, for example, a wedge resection where part of the lung is removed results in less damage than a segmental resection. The procedure would still be preferable to a full lobectomy, where the entire lobe is removed for evaluation. This and other issues may be considered in surgical planning to make the best choice for the patient, given the circumstances.

Sometimes surgical procedures do not go as planned because of complications in surgery or as a result of discovering more growths inside the patient. A surgeon planning a segmental resection of the lung, for example, could find tumors infiltrating the entire lobe. In this situation, the surgeon may move forward with a more aggressive procedure, if this possibility has been discussed ahead of time and the patient has approved.

After a segmental resection, patients may need to wait up to a week for biopsy results. The surgeon could have some information, but not enough to make a definitive diagnosis or start a treatment plan. Once the pathologist has generated a report, the patient can meet with a doctor to decide on the next course of action.