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Evaluation of the Residual Lung Function After Thoracoscopic Segmentectomy Compared With Lobectomy
Shinya Tane1, Wataru Nishio1, Yuki Nishioka1
1Division of Chest Surgery, Hyogo Cancer Center, Akashi City, Japan.
The Annals of Thoracic Surgery
|July 15, 2019
Summary
Thoracoscopic segmentectomy better preserves overall lung function compared to lobectomy. While residual lobe function may decrease post-segmentectomy, the whole lung function remains superior.
Area of Science:
- Thoracic Surgery
- Pulmonary Function Testing
- Medical Imaging
Background:
- Segmentectomy is known to benefit lung function post-resection.
- Quantifying lung volume and function changes after thoracoscopic segmentectomy requires further investigation.
- A novel 3D CT-based volumetric method was employed to assess lung function preservation.
Purpose of the Study:
- To compare residual lung function after thoracoscopic segmentectomy versus lobectomy.
- To evaluate changes in lung volume and function using 3D CT volumetry.
- To correlate lung function preservation rates with resection extent and procedural type.
Main Methods:
- Matched cohort study of 74 segmentectomy and 74 lobectomy patients.
- Pre- and post-operative spirometry and CT scans at 6 months.
- 3D CT volumetry to calculate preserved ipsilateral lobe and contralateral lung volumes.
Main Results:
- Postoperative lung function was significantly better preserved with segmentectomy.
- Ipsilateral unaffected lobe function increased post-resection; residual lobe function decreased.
- Preservation rates correlated inversely with resection extent and positively with unaffected lobe extent.
Conclusions:
- Segmentectomy offers superior whole lung function preservation compared to lobectomy.
- Despite greater-than-predicted residual lobe function decrease with larger resections, overall lung function is better preserved.
- Typical and atypical segmentectomy showed similar residual lobe preservation rates.
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