Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy
Abstract Background The aim of this study was to evaluate regional postoperative preserved pulmonary function (PPPF) and three‐dimensional (3D) volumetric changes according to the number of resected subsegments and investigate the factors that most affected pre‐/post PPPF. Methods Patients who under...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-04-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.13841 |
| _version_ | 1818877679508652032 |
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| author | Hiroaki Kuroda Shozo Sakata Yusuke Takahashi Takeo Nakada Yuko Oya Yusuke Sugita Noriaki Sakakura Hiroakazu Matushita Yukinori Sakao |
| author_facet | Hiroaki Kuroda Shozo Sakata Yusuke Takahashi Takeo Nakada Yuko Oya Yusuke Sugita Noriaki Sakakura Hiroakazu Matushita Yukinori Sakao |
| author_sort | Hiroaki Kuroda |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to evaluate regional postoperative preserved pulmonary function (PPPF) and three‐dimensional (3D) volumetric changes according to the number of resected subsegments and investigate the factors that most affected pre‐/post PPPF. Methods Patients who underwent thoracoscopic lobectomy (n = 73), and segmentectomy (n = 87) were eligible for inclusion in the study. They were classified according to the number of resected subsegments which ranged from 1 to 10. The percentage of pre‐/postoperative forced expiratory volume in 1 s (FEV1) was used for comparison. Furthermore, lung volumetric changes were calculated using 3D computed tomography (CT) volumetry. Results The percentage of pre‐/postoperative EFV1 between 4 and 5–7 and between 5–7 and 10 were significant (p = 0.03 and p < 0.01, respectively), but not between 1–2 to 4 (p = 0.99). The difference between volumetric changes in the left lower lobe of patients with a number of resected subsegments was significant (p < 0.01). On univariate and multivariate analyses, chronic inflammation was significant for decrease in recovery percentages. When the PPPF was compared among resected subsegments, it gradually decreased with an increase in the number of patients without a postoperative procrastination of inflammation (p < 0.01). Conclusions Segmentectomy is feasible and useful for PPPF. Even a relatively large‐volume resection procedure where 5–7 subsegments are resected can preserve pulmonary function. Chronic inflammation was statistically identified as a risk factor for postoperative preserved pulmonary function. Key points |
| first_indexed | 2024-12-19T14:02:07Z |
| format | Article |
| id | doaj.art-c6b1742a4faa4d60ba7ce36261bde0bb |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-19T14:02:07Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-c6b1742a4faa4d60ba7ce36261bde0bb2022-12-21T20:18:25ZengWileyThoracic Cancer1759-77061759-77142021-04-011271033104010.1111/1759-7714.13841Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopyHiroaki Kuroda0Shozo Sakata1Yusuke Takahashi2Takeo Nakada3Yuko Oya4Yusuke Sugita5Noriaki Sakakura6Hiroakazu Matushita7Yukinori Sakao8Department of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Thoracic Surgery Aichi Cancer Center Hospital Nagoya JapanDepartment of Translational Oncoimmunology Aichi Cancer Research Institute Nagoya JapanDepartment of Surgery, Division of Thoracic Surgery The Teikyo University Tokyo JapanAbstract Background The aim of this study was to evaluate regional postoperative preserved pulmonary function (PPPF) and three‐dimensional (3D) volumetric changes according to the number of resected subsegments and investigate the factors that most affected pre‐/post PPPF. Methods Patients who underwent thoracoscopic lobectomy (n = 73), and segmentectomy (n = 87) were eligible for inclusion in the study. They were classified according to the number of resected subsegments which ranged from 1 to 10. The percentage of pre‐/postoperative forced expiratory volume in 1 s (FEV1) was used for comparison. Furthermore, lung volumetric changes were calculated using 3D computed tomography (CT) volumetry. Results The percentage of pre‐/postoperative EFV1 between 4 and 5–7 and between 5–7 and 10 were significant (p = 0.03 and p < 0.01, respectively), but not between 1–2 to 4 (p = 0.99). The difference between volumetric changes in the left lower lobe of patients with a number of resected subsegments was significant (p < 0.01). On univariate and multivariate analyses, chronic inflammation was significant for decrease in recovery percentages. When the PPPF was compared among resected subsegments, it gradually decreased with an increase in the number of patients without a postoperative procrastination of inflammation (p < 0.01). Conclusions Segmentectomy is feasible and useful for PPPF. Even a relatively large‐volume resection procedure where 5–7 subsegments are resected can preserve pulmonary function. Chronic inflammation was statistically identified as a risk factor for postoperative preserved pulmonary function. Key pointshttps://doi.org/10.1111/1759-7714.13841forced expiratory volumeleft upper lobelobectomysegmentectomythoracoscopic surgery |
| spellingShingle | Hiroaki Kuroda Shozo Sakata Yusuke Takahashi Takeo Nakada Yuko Oya Yusuke Sugita Noriaki Sakakura Hiroakazu Matushita Yukinori Sakao Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy Thoracic Cancer forced expiratory volume left upper lobe lobectomy segmentectomy thoracoscopic surgery |
| title | Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy |
| title_full | Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy |
| title_fullStr | Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy |
| title_full_unstemmed | Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy |
| title_short | Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy |
| title_sort | subsegmental resection preserves regional pulmonary function a focus on thoracoscopy |
| topic | forced expiratory volume left upper lobe lobectomy segmentectomy thoracoscopic surgery |
| url | https://doi.org/10.1111/1759-7714.13841 |
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