Mechanical injuries to the ipsilateral non-diseased lobes(s) during pulmonary resection--another factor causing...

The occurrence of complications after major pulmonary resection is known to be related to various factors. However, peri-surgical injuries to the ipsilateral non-diseased lobes(s) occurring during resection have never been mentioned in the literature. This study aimed to verify the injury in cases after lobectomy and wedge resection.

Data from eighteen patients who underwent lobectomy or wedge resection for malignant tumor between January 2003 and January 2004 were collected. All patients had pre- and postoperative examinations of alveolar-capillary membrane (A/C) permeability using 99m TC-DPTA radioaerosol.

Ten lobectomies and eight wedge resection were performed. Using the paired t-test with each patient's pre-operative A/C permeability as his own control data, the postoperative A/C permeability of the ipsilateral non-diseased lobe(s) was found to be significantly increased. The degree of increase in the lobectomy group was the same as that in the wedge resection group. However, no significant change was found on the contralateral side in both groups.

The degree of increase of permeability was the same in both groups, indicating that the effects of stretch on the surviving lung are not a contributing factor to the change in A/C permeability. The mechanical injuries during the pulmonary surgical procedure alter the permeability, which could be a possible factor causing postoperative pulmonary complications.