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Gross Anatomy of the Lungs

Gross Anatomy of the Lungs

The lungs are a pair of vital organs connected to the trachea via the left and right bronchi. The base of these organs meets the dome-shaped muscle known as the diaphragm. Encased by the pleurae, the lungs contact the mediastinum. The right lung is shorter yet wider, and has a larger volume than the left lung. The left lung has an indentation known as the cardiac notch. The superior region of the lungs is referred to as the apex, whereas the base is the lower region near the diaphragm. The...

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Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome

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Lung segmentectomy: does it offer a real functional benefit over lobectomy?

Anne Charloux^1,2, Elisabeth Quoix³

¹Physiology and Functional Explorations Dept, University Hospital, Strasbourg, France anne.charloux@chru-strasbourg.fr.

European Respiratory Review : an Official Journal of the European Respiratory Society

|October 27, 2017

Summary

Anatomical segmentectomy preserves pulmonary function better than lobectomy for early lung cancer. While segmentectomy shows a lower decrease in forced expiratory volume in 1 second (FEV1), its functional benefit over lobectomy needs further study, especially in patients with poor lung function.

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Area of Science:

Thoracic Surgery
Pulmonary Medicine
Surgical Oncology

Background:

Anatomical segmentectomy is a lung-sparing alternative to lobectomy for early-stage lung cancer.
Evaluating the functional outcomes of segmentectomy compared to lobectomy is crucial for patient management.

Purpose of the Study:

To assess the extent of pulmonary function decrease after segmentectomy.
To determine if segmentectomy offers a functional benefit over lobectomy in early-stage lung cancer patients.

Main Methods:

Systematic review and analysis of existing literature on pulmonary function after segmentectomy and lobectomy.
Comparison of changes in forced expiratory volume in 1 second (FEV1) between the two surgical approaches.

Main Results:

Segmentectomy results in a lower mean decrease in FEV1 (-9% to -24% at 2 months, -3% to -13% at 12 months) compared to lobectomy.
The functional benefit of segmentectomy over lobectomy is modest and not definitively established in patients with pre-existing poor lung function.

Conclusions:

Anatomical segmentectomy offers better pulmonary function preservation than lobectomy for stage IA lung cancer.
Further research, including randomized trials, is needed to clarify the functional benefits of segmentectomy, particularly in vulnerable patient populations and in comparison to other ablative therapies.