Pulmonary-function changes after uniportal video-assisted thoracoscopic anatomical lung resection

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Oncology

Background:

• The impact of segmentectomy versus lobectomy on pulmonary function preservation remains debated.
• Uniportal video-assisted thoracoscopic surgery (VATS) offers a minimally invasive approach for anatomical lung resection.

Purpose of the Study:

• To investigate pulmonary function changes after uniportal VATS anatomical lung resection based on the number of segments removed.
• To establish a relationship between the extent of resection and pulmonary function decline.

Main Methods:

• Retrospective review of 135 patients undergoing uniportal VATS anatomical lung resection (April 2015 - December 2020).
• Pulmonary function assessed by forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1).
• Patients categorized by resected segments: one (n=33), two (n=22), three (n=40), four (n=15), and five (n=25).

Main Results:

• FVC loss was significantly higher in five-segment resections (10.8%) compared to one-segment (0.97%) and two-segment (2.44%) resections.
• FEV1 loss was significantly greater in five-segment resections (15.02%) versus one-segment (3.83%), two-segment (4.63%), and three-segment (7.63%) resections.
• A linear increase in both FVC and FEV1 loss was observed with an increasing number of resected segments, averaging 2.16% for FVC and 3.00% for FEV1 per segment.

Conclusions:

• Uniportal VATS anatomical lung resection involving fewer segments is associated with superior pulmonary function preservation.
• Pulmonary function loss demonstrates a linear correlation with the number of segments resected, approximately 2%-3% per segment.