Postoperative change in pulmonary function of the ipsilateral preserved lung after segmentectomy versus lobectomy

Objective: Anatomical repositioning and expansion of the ipsilateral preserved lung after lung resection may influence postoperative pulmonary function. To study the postoperative changes in pulmonary function of the preserved lung after lobectomy compared with that after segmentectomy, the preoperative and postoperative forced expiratory volume in 1s (FEV(1)) of the ipsilateral non-operated lobe was measured using perfusion single-photon-emission computed tomography and computed tomography (SPECT/CT).

Methods: Eighty-nine patients (n=24; lobectomy, n=65; segmentectomy) who were examined with pulmonary function test and perfusion SPECT/CT both before and after surgery were enrolled in this study. The FEV(1) values of the ipsilateral non-operated lobes before and after surgery were measured using perfusion SPECT/CT.

Results: The FEV(1) of the ipsilateral non-operated lobe increased after segmentectomy of the right upper lobe (p=0.07) and after both lobectomy and segmentectomy of the left upper lobe (p=0.04 and 0.001, respectively), but decreased after lobectomy of the right upper lobe (p=0.06). In the right upper lobe, the percentage change in FEV(1) of the ipsilateral non-operated lobe after lobectomy was significantly lower than that after segmentectomy (p<0.001). The FEV(1) of the ipsilateral non-operated lobe had not significantly changed after surgery on the lower lobes.

Conclusions: The FEV(1) of the ipsilateral non-operated lobes increased after surgery on left upper lobe, whereas it decreased after right upper lobectomy. The surgery on lower lobe did not affect the FEV(1) of the ipsilateral non-operated lobes. Our data may facilitate determining the indications for lung cancer surgery, especially in patients with tumours involving the upper lobes.