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Combined subsegmentectomy: postoperative pulmonary function compared to multiple segmental resection.

Yoshimoto K, Nomori H, Mori T, Ohba Y, Shiraishi K, Ikeda K - J Cardiothorac Surg (2011)

Bottom Line: Tumor size, location of tumor, and forced expiratory volume in 1 second (FEV1) of each preserved lobe were compared among the CSS, resection of single segment, and that of multiple segments.Mean FEV1 of each preserved lobe per subsegment after CSS was significantly higher than that after resection of multiple segments (0.05±0.03 vs. 0.03±0.02 l, p=0.02).The CSS is effective for preserving pulmonary function of each lobe, especially for small sized lung cancer involving multiple segments in the right upper lobe, which has fewer segments than other lobes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan.

ABSTRACT

Background: For small peripheral c-T1N0M0 non-small cell lung cancers involving multiple segments, we have conducted a resection of subsegments belonging to different segments, i.e. combined subsegmentectomy (CSS), to avoid resection of multiple segments or lobectomy. Tumor size, location of tumor, and forced expiratory volume in 1 second (FEV1) of each preserved lobe were compared among the CSS, resection of single segment, and that of multiple segments.

Methods: FEV1 of each preserved lobe were examined in 17 patients who underwent CSS, 56 who underwent resection of single segment, and 41 who underwent resection of multiple segments, by measuring pulmonary function and lung-perfusion single-photon-emission computed tomography and computed tomography before and after surgery.

Results: Tumor size in the CSS was significantly smaller than that in the resection of multiple segments (1.4±0.5 vs. 2.0±0.8 cm, p=0.002). Tumors in the CSS were located in the right upper lobe more frequently than those in the resection of multiple segments (53% vs. 5%, p<0.001). Postoperative of FEV1 of each lobe after the CSS was higher than that after the resection of multiple segments (0.3±0.2 vs. 0.2±0.2 l, p=0.07). Mean FEV1 of each preserved lobe per subsegment after CSS was significantly higher than that after resection of multiple segments (0.05±0.03 vs. 0.03±0.02 l, p=0.02). There was no significant difference of these factors between the CSS and resection of single segment.

Conclusions: The CSS is effective for preserving pulmonary function of each lobe, especially for small sized lung cancer involving multiple segments in the right upper lobe, which has fewer segments than other lobes.

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Related in: MedlinePlus

Images of before and after segmentectomy. (a) Coronal image of CT before surgery, showing a lung cancer (arrow) in the segment 2b of right upper lobe. (b) Coronal image of the perfusion SPECT/CT of the right upper lobe before operation. (c) Coronal image of the perfusion SPECT/CT of the remaining right upper lobe after the resection of S2b and S3a.
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Figure 2: Images of before and after segmentectomy. (a) Coronal image of CT before surgery, showing a lung cancer (arrow) in the segment 2b of right upper lobe. (b) Coronal image of the perfusion SPECT/CT of the right upper lobe before operation. (c) Coronal image of the perfusion SPECT/CT of the remaining right upper lobe after the resection of S2b and S3a.

Mentions: Images of the lobe before segmentectomy and of the lobe remaining after segmentectomy were traced on the CT image with a region of interest, of which radioisotope (RI) was counted on the SPECT image (Figure 2).


Combined subsegmentectomy: postoperative pulmonary function compared to multiple segmental resection.

Yoshimoto K, Nomori H, Mori T, Ohba Y, Shiraishi K, Ikeda K - J Cardiothorac Surg (2011)

Images of before and after segmentectomy. (a) Coronal image of CT before surgery, showing a lung cancer (arrow) in the segment 2b of right upper lobe. (b) Coronal image of the perfusion SPECT/CT of the right upper lobe before operation. (c) Coronal image of the perfusion SPECT/CT of the remaining right upper lobe after the resection of S2b and S3a.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3050688&req=5

Figure 2: Images of before and after segmentectomy. (a) Coronal image of CT before surgery, showing a lung cancer (arrow) in the segment 2b of right upper lobe. (b) Coronal image of the perfusion SPECT/CT of the right upper lobe before operation. (c) Coronal image of the perfusion SPECT/CT of the remaining right upper lobe after the resection of S2b and S3a.
Mentions: Images of the lobe before segmentectomy and of the lobe remaining after segmentectomy were traced on the CT image with a region of interest, of which radioisotope (RI) was counted on the SPECT image (Figure 2).

Bottom Line: Tumor size, location of tumor, and forced expiratory volume in 1 second (FEV1) of each preserved lobe were compared among the CSS, resection of single segment, and that of multiple segments.Mean FEV1 of each preserved lobe per subsegment after CSS was significantly higher than that after resection of multiple segments (0.05±0.03 vs. 0.03±0.02 l, p=0.02).The CSS is effective for preserving pulmonary function of each lobe, especially for small sized lung cancer involving multiple segments in the right upper lobe, which has fewer segments than other lobes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan.

ABSTRACT

Background: For small peripheral c-T1N0M0 non-small cell lung cancers involving multiple segments, we have conducted a resection of subsegments belonging to different segments, i.e. combined subsegmentectomy (CSS), to avoid resection of multiple segments or lobectomy. Tumor size, location of tumor, and forced expiratory volume in 1 second (FEV1) of each preserved lobe were compared among the CSS, resection of single segment, and that of multiple segments.

Methods: FEV1 of each preserved lobe were examined in 17 patients who underwent CSS, 56 who underwent resection of single segment, and 41 who underwent resection of multiple segments, by measuring pulmonary function and lung-perfusion single-photon-emission computed tomography and computed tomography before and after surgery.

Results: Tumor size in the CSS was significantly smaller than that in the resection of multiple segments (1.4±0.5 vs. 2.0±0.8 cm, p=0.002). Tumors in the CSS were located in the right upper lobe more frequently than those in the resection of multiple segments (53% vs. 5%, p<0.001). Postoperative of FEV1 of each lobe after the CSS was higher than that after the resection of multiple segments (0.3±0.2 vs. 0.2±0.2 l, p=0.07). Mean FEV1 of each preserved lobe per subsegment after CSS was significantly higher than that after resection of multiple segments (0.05±0.03 vs. 0.03±0.02 l, p=0.02). There was no significant difference of these factors between the CSS and resection of single segment.

Conclusions: The CSS is effective for preserving pulmonary function of each lobe, especially for small sized lung cancer involving multiple segments in the right upper lobe, which has fewer segments than other lobes.

Show MeSH
Related in: MedlinePlus