How preserved regional pulmonary function after thoracoscopic segmentectomy in clinical stage I non-small cell lung cancers in right upper lobe

Sugita, Yoshimitsu; Kuroda, Hiroaki; Sakata, Shozo; Sakao, Yukinori; Okubo, Kan

doi:10.1007/s11748-020-01561-6

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…However, previous studies have noticed that due to various reasons (different pulmonary function interval time, impacts caused by surgical incisions and different re-expansion after various extent of resection, etc. ), postoperative pulmonary function might be inaccurately predicted by segment counting method [ 23 – 25 ]. It is difficult to determine precisely whether a patient is fit for VATS segmentectomy.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules

Feng

Shen

et al. 2022

BMC Surg

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Background In the treatment of peripheral early-staged lung cancer and benign lesions, segmentectomy and wedge resection are both reliable treatment methods. It is debatable that how much pulmonary function will be lost after different sublobar resection in the treatment of early-staged deep-located peripheral NSCLC (non-small cell lung cancer). The purpose of this study was to explore postoperative pulmonary function changes of sublobar resection in enrolled patients with non-subpleural peripheral nodules. Methods We collected clinical data of patients undergoing VATS (video-assisted thoracoscopic surgery) segmentectomy or wedge resection for single nodule. These nodules were confirmed as peripheral non-subpleural nodules by preoperative 3D imaging. Patients were divided into two groups according to the operation procedure. Demographic characteristics, pulmonary function, postoperative outcomes, and others were collected. All data was gathered at the First Affiliated Hospital of Soochow University. Outcomes after wedge resection were compared with those after segmentectomy resection. Results A total of 88 patients were included in this study, including 46 patients with VATS wedge resection and 42 patients with VATS segmentectomy. No difference was detected when comparing FEV1 (forced expiratory volume in 1 s) loss between these two groups (17.6 ± 2.1%, wedge resection vs. 19.4 ± 5.4%, segmentectomy, P = 0.176). FVC (forced vital capacity) loss (8.7 ± 2.3%, wedge resection vs. 17.1 ± 2.2%, segmentectomy, P < 0.001) and MVV (maximum ventilatory volume) loss (11.5 ± 3.1%, wedge resection vs. 20.6 ± 7.8%, segmentectomy, P < 0.001) in segmentectomy group was significantly higher than those in wedge resection group. Discrepancies were investigated when comparing duration of surgery (70 ± 22 min, wedge resection vs. 111 ± 52 min, segmentectomy, P = 0.0002), postoperative drainage (85 ± 45 mL, wedge resection vs. 287 ± 672 mL, segmentectomy, P = 0.0123), and treatment hospitalization expenses [35148 ± 889CNY, wedge resection vs. 52,502 (38,276–57,772) CNY, segmentectomy, P < 0.0002]. No significant difference was found between air leak time (1.7 ± 0.7 days, wedge resection vs. 2.5 ± 1.7 days, segmentectomy, P = 0.062) and hospitalization time (2.7 ± 0.7 days, wedge resection vs. 3.5 ± 1.7 days, segmentectomy, P = 0.051). Conclusions For patients with peripheral non-subpleural nodules, we observed that patients who underwent wedge resection had less lung function loss than those who underwent segmentectomy when their lung function was reviewed at the 6th month after surgery. Patients undergoing wedge resection had partial advantages over patients with segmental resection in terms of hospitalization cost, operation time and postoperative drainage, etc. Wedge resection, as a treatment for peripheral non-subpleural pulmonary nodules, seemed to have more advantages in preserving patients’ pulmonary function.

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Section: Discussionmentioning

confidence: 99%

Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules

Feng

Shen

et al. 2022

BMC Surg

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“…O/E functional loss ratio Traditionally, pulmonary function loss after lung resection is thought to be in direct proportion to the number of resected segments, leading to the assumption that segmentectomies might preserve more function than lobectomies. However, previous studies have noticed that pulmonary function after lung resection might be inaccurately predicted by the segment counting method due to various factors including the baseline lung function, different intervals between surgery and the postoperative spirometry test (8,21,22), impacts from the surgical incisions (23,24), different compensatory lung expansion after various extent of resections and various lobes resected (25). In this study, we compared the expected pulmonary function loss with the actual loss observed at a fixed interval between spirometry tests after VATS lung resection in functionally fit patients.…”

Section: Discussionmentioning

confidence: 99%

“…Only a limited number of retrospective small-sample studies have compared functional changes after lobectomy and segmentectomy in the VATS setting (24)(25)(26)(27)(28)(29)(30), among which few explored pulmonary function changes after different segmentectomies (25,29). Tane et al noticed that FEV1 could be better preserved after single segmentectomy than after combined segmentectomy (25).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function changes after thoracoscopic lobectomy versus intentional thoracoscopic segmentectomy for early-stage non-small cell lung cancer

Chen¹,

Gu²,

Lin³

et al. 2021

Transl Lung Cancer Res

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“…[29] However, studies that are more recent have suggested that postoperative lung function is better after segmentectomy. [30][31][32] Tane et al compared residual lung function after VATS lobectomy and segmentectomy using three-dimensional CT volumetry and concluded that although the decrease in lung function in the residual lobe was greater than predicted after segmentectomy, and this functional decrease became greater with increasing extent of resection, whole lung function preservation was better after segmentectomy than after lobectomy. [31] In the present study, no discrepancy was noticed when FEV1 loss between two groups were compared.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function changes after uniportal video-assisted thoracoscopic anatomical lung resection

Sherif

Khalifa

Elsharkawy

2021

ijhs

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Background: Some early staged NSCLC appears as non-subpleural peripheral pulmonary nodules. Thoracic surgeons usually adopt extended wedge resection or segmentectomy to remove these nodules. Video-assisted thoracoscopic surgery (VATS) has been carried out extensively worldwide in lung surgeries. The purpose of this study was to evaluate changes in postoperative pulmonary function changes after undergoing VATS wedge resection and VATS segmentectomy anatomical lung ‏resection. Methods: This retrospective study was carried out on 80 patients scheduled for UVATS sublobar resection lung surgery. Patients were divided equally into two groups according to the surgical procedures, VATS wedge resection group, and VATS segmentectomy group. All patients were subjected to full history taking length of stapler on CT scan, preoperative and postoperative pulmonary function tests include Forced vital capacity (FVC), Forced expiratory volume (FEV1), FEV1/FVC ratio, operation characteristics, postoperative recovery, treatment and hospitalization expenses. Results: FVC loss after segmentectomy was significantly greater than after wedge resection (17.1 ± 1.58%, vs. 7.9 ± 1.59% P < 0.001). Preoperative pulmonary function (FEV1 and FVC) was statistically different between the two groups of patients. Postoperative pulmonary function (FEV1, FVC and FEV1/-FVC) was statistically different between the two groups of patients.

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How preserved regional pulmonary function after thoracoscopic segmentectomy in clinical stage I non-small cell lung cancers in right upper lobe

Cited by 6 publications

References 16 publications

Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules

Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules

Pulmonary function changes after thoracoscopic lobectomy versus intentional thoracoscopic segmentectomy for early-stage non-small cell lung cancer

Pulmonary function changes after uniportal video-assisted thoracoscopic anatomical lung resection

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