Quantitative computed tomography assessment of pulmonary function and compensation after lobectomy and segmentectomy in lung cancer patients

作者：Leqing Chen, Jinrong Yang, Chi Zhang, Lijie Grace Zhang, Xiaoyu Han, Chengjun Dong, Shen Gui, Xiaoqing Liu, Heshui Shi · 发表于：Journal of Thoracic Disease · 年份：2024 · DOI：10.21037/jtd-24-492 · 被引用次数：3 · 研究领域：Lung Cancer Diagnosis and Treatment、Pleural and Pulmonary Diseases、Respiratory Support and Mechanisms

Background: The effect of different surgical methods on postoperative lung function in patients with lung cancer is still inconclusive. The main objective of this study was to compare the effects of video-assisted thoracic surgery (VATS) lobectomy and segmentectomy on postoperative pulmonary function and compensatory changes in patients undergoing lung cancer surgery. Methods: A total of 120 patients (82 VATS lobectomy, 38 VATS segmentectomy) were assessed for demographic characteristics, baseline pulmonary function, tumor volume, T stage, and histological grade. Postoperative pulmonary function and compensatory changes [percentage of the well-aerated lung (WAL) total (or unilateral) lung volume (LV) (WAL%) and non-operated lung (NOL)] were measured at multiple time points up to 2 years. Logistic regression analysis identified factors associated with WAL% decline after 1 year. Results: Both VATS lobectomy and segmentectomy led to a decrease in pulmonary function, with no significant difference in the extent of decline between the two groups (all P>0.05). Lobectomy triggered a more pronounced compensatory response, characterized by increased ipsilateral NOL volume over time. Segmentectomy induced minimal compensatory changes and had a minimal impact on pulmonary function. Factors associated with decreased pulmonary ventilation after 1 year differed between the lobectomy and segmentectomy groups. In the lobectomy group, a higher preoperative WAL% of ipsilateral NOL [odds ratio ...