Functional advantage of parenchymal-sparing surgery for early hilar lung cancer.
In a group of 27 patients with early hilar lung cancer, standard sleeve lobectomy was performed in 14 cases, standard lobectomy in 9 cases, and another 4 patients underwent parenchymal-sparing operations (2 had sleeve segmentectomy, 1 had sleeve middle lobectomy, and 1 had left second carinal resection). The changes of conventional pulmonary function tests and regional pulmonary function were compared between patients undergoing sleeve lobectomy and those undergoing parenchymal-sparing surgery. The parameters used for the conventional lung function tests were FVC, %FVC, FEV1.0, and %FEV1.0. For the evaluation of regional pulmonary function, perfusion scans using 99mTc-MAA and ventilation scans using 133Xe were performed. The decrease of FVC in the sleeve lobectomy group (n = 5) was 724 +/- 182.7 ml, whereas that in the parenchymal- sparing surgery group (n = 4) was 367.5 +/- 52.1 ml, a significant difference. Both the FEV1.0 and %FEV1.0 showed no marked changes in both groups between the preoperative and postoperative values. Perfusion and ventilation scans in the parenchymal-sparing group showed a superior result in comparison with sleeve lobectomy group. All the patients undergoing parenchymal-sparing operations survived over the long term. It was thus concluded that parenchymal-sparing surgery can be applied to carefully selected patients with tiny localized cancers.
Watanabe
Y
Y
Department of Surgery, Kanazawa University School of Medicine.
Oda
M
M
Shimizu
J
J
Hayashi
Y
Y
Ohta
Y
Y
Iwa
T
T
Tonami
N
N
Hisada
K
K
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011877:Radionuclide Imaging; D012129:Respiratory Function Tests