Quantitative Analysis of Changes in the Thoracic Anatomy over Time after Pneumonectomy Using Computed Tomography

Area of Science:

• Thoracic surgery
• Pulmonary medicine
• Radiology

Background:

• Pneumonectomy, a major lung surgery, leads to significant anatomical alterations within the thorax.
• Quantitative analysis of these time-dependent changes has been limited.

Purpose of the Study:

• To quantitatively analyze the time-dependent changes in hemithorax volume reduction, contralateral compensatory hyperinflation, and mediastinal angle shift following pneumonectomy.

Main Methods:

• Retrospective analysis of 119 patients who underwent pneumonectomy.
• Computed tomography (CT) scans were used to quantify hemithorax volumes and mediastinal shift angles preoperatively and at 6 months, 1, 2, and 3 years postoperatively.

Main Results:

• Significant volume reduction in the operated hemithorax (25-37% of original volume) and contralateral hyperinflation (21-24%) were observed over 3 years.
• Mediastinal shift increased significantly post-pneumonectomy, stabilizing after 6 months.
• Left pneumonectomy resulted in a more rapid volume decrease compared to right pneumonectomy.

Conclusions:

• Substantial anatomical changes occur within the first 6 months after pneumonectomy.
• Thoracic structures stabilize by 2-3 years postoperatively, with reduced magnitude of change after the initial 6-month period.