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The effect of lobar shifting following right upper lobectomy on postoperative pulmonary function

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Abstract

Objectives

Lobes occasionally displace after lobectomy, referred to as “lobar shifting”. However, the benefits, especially in postoperative pulmonary function, remain controversial. This study aimed to measure the effect of lobar shifting on postoperative pulmonary function especially in the right upper lobe.

Methods

This retrospective study includes 273 right upper lobectomy patients (lobectomy group) and 24 right upper segmentectomy patients (segmentectomy group) from 2012 to 2021. The lobectomy group was further subdivided based on their Synapse Vincent® image: with their postoperative middle lobe bronchus shifted toward the head (shift group: 176 cases) and without (non-shift group: 97 cases). Several factors were examined to determine the cause of lobar shifting. The rate of measured actual postoperative forced expiratory volume in 1 s (FEV1.0) to predicted postoperative FEV1.0 was analyzed and compared among the three groups.

Results

Factors that correlated with lobar shifting included age (p < 0.001), a relatively small middle lobe volume (p = 0.03), no adhesions (p < 0.001), and good upper/middle and middle/lower lobulation (p = 0.04, p = 0.02). The rate of measured actual postoperative FEV1.0 to predicted postoperative FEV1 for the shift, non-shift, and segmentectomy groups were 112.5%, 107.9%, and 103.1% (shift vs non-shift: p = 0.04, shift vs segmentectomy: p = 0.02, non-shift vs segmentectomy: p = 0.19).

Conclusions

Lobar shifting after right upper lobectomy is influenced by morphological factors and may have a beneficial impact on postoperative pulmonary function.

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Data availability

No data was used for the research described in the article.

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Authors and Affiliations

  1. Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-Cho, Akashi City, 673-8558, Japan

    Sanae Kuroda, Kenji Miura, Nahoko Shimizu, Yoshitaka Kitamura & Wataru Nishio

Authors
  1. Sanae Kuroda
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  2. Kenji Miura
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  3. Nahoko Shimizu
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  4. Yoshitaka Kitamura
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  5. Wataru Nishio
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Correspondence to Sanae Kuroda.

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None declared.

Date and number of IRB approval

G-304. December, 27, 2022.

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Kuroda, S., Miura, K., Shimizu, N. et al. The effect of lobar shifting following right upper lobectomy on postoperative pulmonary function. Gen Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s11748-024-02019-9

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  • DOI: https://doi.org/10.1007/s11748-024-02019-9

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