Quantification of the impact of segmentectomy on pulmonary function by perfusion single-photon-emission computed tomography and multidetector computed tomography

J Thorac Cardiovasc Surg. 2009 May;137(5):1200-5. doi: 10.1016/j.jtcvs.2008.10.028.

Abstract

Objective: The impact of segmentectomy for preservation of pulmonary function was quantified by using a co-registered perfusion single-photon-emission computed tomography and multidetector computed tomography (SPECT/CT).

Methods: Pulmonary function tests and perfusion SPECT/CT were conducted before and after segmentectomy in 56 patients. Actual values of forced expiratory volume in 1 second (FEV(1)) after segmentectomy were compared with the FEV(1) after virtual lobectomy, which was calculated by SPECT/CT. The preoperative and postoperative FEV(1) of each lobe that had undergone segmentectomy was measured by SPECT/CT.

Results: The mean percent of FEV(1) preserved after segmentectomy was significantly higher than the value after virtual lobectomy (88% +/- 9% vs 77% +/- 7%; P < .001). Whereas the mean value of the preoperative FEV(1) of each lobe that was undergoing segmentectomy was 0.51+/-0.21 L, segmentectomy could preserve 41% +/- 24% of it. The FEV(1) of each lobe after the resection of more than three segments (n = 4) was preserved in 17% +/- 12% of the preoperative values, which was significantly less than 49% +/- 23% and 35% +/- 22% after the resection of one (n = 29) and two (n = 23) segments (P = .02 and .08, respectively). The FEV(1) of the left upper lobe after the upper division segmentectomy (n = 8) was preserved in 21% +/- 11% of the preoperative values, which was significantly less than 35% +/- 12% after the lingular segmentectomy (n = 7) (P = .03).

Conclusion: Segmentectomy can preserve the pulmonary function more significantly than lobectomy, except for the resection of more than three segments or the left upper division segmentectomy.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Cohort Studies
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pneumonectomy / methods*
  • Postoperative Care
  • Preoperative Care
  • Respiratory Function Tests
  • Risk Assessment
  • Sensitivity and Specificity
  • Survival Analysis
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vital Capacity