An analysis of residual lung volume changes after segmentectomy based on three-dimensional computed tomography

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Oncology

Background:

• Segmentectomy is a standard procedure for early-stage non-small cell lung cancer (NSCLC).
• Post-lobectomy, the lungs exhibit compensatory volume changes and mediastinal shifts.
• Assessing segmentectomy's impact on postoperative lung volume and function is crucial.

Purpose of the Study:

• To evaluate the efficacy of segmentectomy in early-stage NSCLC by analyzing postoperative lung volume changes.
• To identify factors associated with compensatory lung volume increase after segmentectomy.
• To determine the impact of segmentectomy on overall lung function.

Main Methods:

• Seventy-seven patients undergoing segmentectomy were analyzed.
• Postoperative lung volume increase rate was calculated using predicted residual volume and actual postoperative volume.
• Patients were classified into compensatory (≥100% increase) and non-compensatory (<100% increase) groups.

Main Results:

• Average postoperative lung volume increase was 104.6% in 77 patients.
• Factors associated with compensatory increase included age ≥65, high pack-year index, ≥3 resected segments, and electrocautery use.
• Compensatory group showed improved postoperative vital capacity and forced expiratory volume in one second compared to preoperative predictions.

Conclusions:

• Segmentectomy leads to significant compensatory volume changes in the ipsilateral and contralateral lungs without reducing residual segment volume.
• Preserving lung segments during surgery is vital for maintaining lung function.
• Postoperative compensatory lung expansion involves both hyperinflation and increased functional lung parenchyma, suggesting segmentectomy's potential to enhance treatment outcomes.