[Changes in pulmonary function after bilateral lung resection]

Recently, bilateral lung resection are often performed as a treatment of both sides of emphysematous bullae or metastatic lung tumor. In our studies, general status and pulmonary function after the surgery were well maintained in most patients treated with partial lung resection or bullectomy. However, in cases received the resection of three or more segments on both side of the lung, vital capacity after the second surgery decreased in greater degree than was expected from the total volume of lung removed, and their Hugh-Jones grades for dyspnea proceeded postoperatively to II degrees or III degrees. Postoperative disturbance in pulmonary function is an important problem in cases of bilateral lung resection in numbers of segments. We studied experimentally on changes of pleural pressure and pressure-volume curve (P-V curve) of the remaining lung lobe and chest wall after bilateral lobectomy. Pleural pressure became more subatmospheric following the lobectomies, i.e., the functional residual capacity of the remaining lobe increased. The compliance of the remaining lobe decreased after lobectomies and the P-V curves were shifted to the right, resulted in decrease of the lung volume under the condition of a high grade of inspiration, i.e., reducing vital capacity.