Pulmonary Function After Lobectomy Versus Segmentectomy in Patients with Stage I Non-Small Cell Lung Cancer

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• 作者：Hajime Saito (1)
  Taku Nakagawa (1)
  Manabu Ito (1)
  Kazuhiro Imai (1)
  Takashi Ono (1)
  Yoshihiro Minamiya (1)
  
• 刊名：World Journal of Surgery
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：38
• 期：8
• 页码：2025-2031
• 全文大小：314 KB
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• 作者单位：Hajime Saito (1)
  Taku Nakagawa (1)
  Manabu Ito (1)
  Kazuhiro Imai (1)
  Takashi Ono (1)
  Yoshihiro Minamiya (1)
  
  1. Division of Thoracic Surgery, Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
  
• ISSN：1432-2323

文摘

Background Several reports have shown that segmentectomy is superior to lobectomy for preservation of postoperative pulmonary function. The purpose of this study was to characterize the relationship between pulmonary function and the volume of the resected lung in patients undergoing segmentectomy or lobectomy. Methods Patients undergoing open lobectomy (n?=?126) and open segmentectomy (n?=?52) for stage I non-small cell lung cancer were analyzed retrospectively. Pulmonary function testing, including vital capacity (VC) and forced expiratory volume in 1 second (FEV1), was performed preoperatively and at 1 and 6?months postoperatively. Results The postoperative reduction of VC and FEV1, as indicated by the postoperative value/preoperative value, at 6?months after surgery was significantly less in the segmentectomy group than in the lobectomy group. However, the standardized functional loss ratio, as expressed by [(measured postoperative value)-predicted postoperative value)] / (predicted postoperative value)?×?100 (%), at 1?month after surgery was significantly lower in the segmentectomy group than in the lobectomy group. No significant difference in the standardized functional loss ratio was seen at 6?months postoperatively. Conclusions Pulmonary function at 6?months after surgery is better after segmental resection than after lobectomy. However, the absolute value of pulmonary function did not reach the predicted-postoperative value at 1?month after surgery. Thus, when segmentectomy is performed, clinicians should be aware that early postoperative pulmonary function may be significantly less than the expected value.