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Lobectomy Induces Exercise-Induced Pulmonary Hypertension and Effort Intolerance Compared With Sublobar Resection
Atsushi Kamigaichi1, Yasuhiro Tsutani2, Akane Tsuchiya3
1Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
JTO Clinical and Research Reports
|October 27, 2025
Summary
Sublobar resection (SR) preserves lung function better than lobectomy. SR leads to less pulmonary hypertension and better exercise capacity post-surgery, emphasizing the benefits of lung parenchyma preservation.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Cardiopulmonary Physiology
Background:
- The benefits of parenchyma-preserving sublobar resection (SR) over lobectomy are not fully understood.
- Investigating postoperative cardiopulmonary function differences between SR and lobectomy is crucial.
Purpose of the Study:
- To compare cardiopulmonary function changes after lobectomy versus sublobar resection (SR).
- To evaluate the impact of lung-sparing surgery on exercise capacity and pulmonary hemodynamics.
Main Methods:
- Prospective observational study involving patients undergoing lobectomy or SR.
- Cardiopulmonary function assessed at 6 months post-surgery using exercise stress echocardiography and cardiopulmonary exercise tests.
Main Results:
- Lobectomy group showed significantly higher systolic pulmonary artery pressure (SPAP) increase during exercise (p=0.001).
- Exercise-induced pulmonary hypertension (exPH) occurred in 45% of lobectomy patients vs. 0% in SR group (p=0.010).
- Peak oxygen consumption decreased more in the lobectomy group (p=0.024), correlating with resected segments.
Conclusions:
- Lobectomy results in increased exercise-induced SPAP, exPH, and reduced exercise tolerance compared to SR.
- These findings underscore the importance of lung parenchyma preservation in surgical interventions.
