title: 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.
abstract: OBJECTIVE
  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 (FEV(1)) 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 FEV(1) 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 FEV(1) 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 FEV(1) 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, FEV(1) 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.
  
  
  CONCLUSIONS
  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 FEV(1) of the RML.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mori
authors.forename: Yasuomi
authors.initials: Y
authors.lastname: Ohba
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Shibata
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Tashiro
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed