Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy

Thoracic Cancer

Yukinori Sakao¹  Yuko Oya²  Noriaki Sakakura²  Hiroaki Kuroda²  Yusuke Takahashi²  Shozo Sakata²  Takeo Nakada²  Yusuke Sugita²  Hiroakazu Matushita³ 

[1] Department of Surgery, Division of Thoracic Surgery The Teikyo University Tokyo Japan;Department of Thoracic Surgery Aichi Cancer Center Hospital Nagoya Japan;Department of Translational Oncoimmunology Aichi Cancer Research Institute Nagoya Japan;

关键词: forced expiratory volume;    left upper lobe;    lobectomy;    segmentectomy;    thoracoscopic surgery;   

DOI  :  10.1111/1759-7714.13841

来源: DOAJ

【 摘 要 】

Abstract Background The aim of this study was to evaluate regional postoperative preserved pulmonary function (PPPF) and three‐dimensional (3D) volumetric changes according to the number of resected subsegments and investigate the factors that most affected pre‐/post PPPF. Methods Patients who underwent thoracoscopic lobectomy (n = 73), and segmentectomy (n = 87) were eligible for inclusion in the study. They were classified according to the number of resected subsegments which ranged from 1 to 10. The percentage of pre‐/postoperative forced expiratory volume in 1 s (FEV1) was used for comparison. Furthermore, lung volumetric changes were calculated using 3D computed tomography (CT) volumetry. Results The percentage of pre‐/postoperative EFV1 between 4 and 5–7 and between 5–7 and 10 were significant (p = 0.03 and p < 0.01, respectively), but not between 1–2 to 4 (p = 0.99). The difference between volumetric changes in the left lower lobe of patients with a number of resected subsegments was significant (p < 0.01). On univariate and multivariate analyses, chronic inflammation was significant for decrease in recovery percentages. When the PPPF was compared among resected subsegments, it gradually decreased with an increase in the number of patients without a postoperative procrastination of inflammation (p < 0.01). Conclusions Segmentectomy is feasible and useful for PPPF. Even a relatively large‐volume resection procedure where 5–7 subsegments are resected can preserve pulmonary function. Chronic inflammation was statistically identified as a risk factor for postoperative preserved pulmonary function. Key points

【 授权许可】

Unknown