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Thoracic cavity remodeling and pulmonary function change after chest wall resection
Seon Yong Bae1, Ji Hyeon Park1, Bubse Na1
1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Journal of Thoracic Disease
|June 17, 2024
Summary
Chest wall resection (CWR) significantly reduces long-term pulmonary function, particularly forced vital capacity and FEV1, especially after resecting three or more ribs. Thoracic cavity volume changes did not correlate with these pulmonary function declines.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Medical Imaging
Background:
- Chest wall resection (CWR) is crucial for managing chest wall malignancies and infections.
- Limited research exists on CWR's impact on pulmonary function and thoracic cavity volume (TCV).
Purpose of the Study:
- To investigate the long-term effects of CWR on TCV and pulmonary function.
- To analyze changes in TCV and pulmonary function one year post-CWR.
Main Methods:
- Retrospective review of 45 patients undergoing CWR between 2001-2021.
- Exclusion of patients with single rib or wedge resections.
- TCV measurement via CT scans; analysis of pulmonary function tests (FVC, FEV1, DLCO).
Main Results:
- Significant long-term decreases in FVC (-7.9%) and FEV1 (-7.0%) post-CWR.
- No significant changes in FEV1/FVC ratio, DLCO, or overall TCV.
- Resection of ≥3 ribs led to significant decreases in FVC, FEV1, and TCV.
- No correlation found between TCV changes and pulmonary function decline.
Conclusions:
- CWR results in significant long-term pulmonary function impairment.
- The extent of impairment is greater with resection of three or more ribs.
- TCV changes do not directly correlate with the observed pulmonary function deficits.
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