Dividing inferior pulmonary ligament may change the bronchial angle

Whether dissecting the inferior pulmonary ligaments (IPLs) during superior video-assisted thoracoscopic (VATS) lobectomy for early stage lung cancer remains controversial. This study aimed to evaluate the influence of dissecting the IPLs during VATS superior lobectomy on bronchial distortion and recovery of pulmonary function.

This was a retrospective study of 72 patients with non-small cell lung cancer who underwent VATS superior lobectomy from March 2012-August 2013 at the First People's Hospital of Yunnan Province. Patients were grouped according to IPLs preservation (group P) or dissection (group D). The preoperative and postoperative pulmonary function and the postoperative complications were analyzed. The changes in bronchi angles and pulmonary capacity were measured using computed tomography.

There were no significant differences in the complication rate and volume of chest drainage between the two groups. The changes in bronchus angle in group P were significantly smaller than those in group D after left lung operation (P = 0.046 at 3 mo; P = 0.038 at 6 mo); in the right lung, the changes were not significant between the two groups (P = 0.057 at 3 mo; P = 0.541 at 6 mo). The forced expiratory volume of 2% and forced expiratory volume in 1 s (FEV1%) were significantly better in group P than those in group D at 3 and 6 mo (P < 0.05). The pulmonary capacity in group P was significantly larger than that in group D at 6 mo (P = 0.002).

Preservation of IPLs during VATS lobectomy might have an impact on the bronchus angle, lung function, and lung volume.