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A segmentectomy of the right upper lobe has an advantage over a right upper lobectomy regarding the preservation of the functional volume of the right middle lobe: Analysis by perfusion single-photon emission computed tomography/computed tomography

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Abstract

Purpose

To evaluate the advantages of a segmentectomy of the right upper lobe (RUL) over a right upper (RU) lobectomy regarding the preservation of the functional volume of the right middle lobe (RML), the postoperative forced expiratory volume in one second (FEV1) of the RML was compared between an RU lobectomy and an RUL segmentectomy, by using a coregistered perfusion single-photon emission computed tomography and computed tomography (SPECT/CT).

Methods

The pulmonary function tests and perfusion SPECT/CT were conducted before and after surgery (RU lobectomy: 7; RUL segmentectomy: 13). The FEV1 of the RML before and after surgery was calculated from the data of the pulmonary function test and SPECT/CT.

Results

In the RU lobectomy group, the percentage change of FEV1 was 71% ± 12%, which was significantly lower in comparison to 92% ± 9% in the RUL segmentectomy group (P = 0.001). In the lobectomy group, the preoperative FEV1 of the RML was 0.17 ± 0.10 l, which decreased significantly to 0.06 ± 0.06l after surgery (P = 0.009). In the segmentectomy group, FEV1 of the RML before and after the surgery were 0.23 ± 0.10 l and 0.20 ± 0.111, of which the difference was not significant.

Conclusion

An RUL segmentectomy has an advantage over an RU lobectomy regarding the preservation of pulmonary function, due to a greater preservation of not only the lung tissue, but also the FEV1 of the RML.

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Yoshimoto, K., Nomori, H., Mori, T. et al. A segmentectomy of the right upper lobe has an advantage over a right upper lobectomy regarding the preservation of the functional volume of the right middle lobe: Analysis by perfusion single-photon emission computed tomography/computed tomography. Surg Today 40, 614–619 (2010). https://doi.org/10.1007/s00595-009-4103-9

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  • DOI: https://doi.org/10.1007/s00595-009-4103-9

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