JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Hiroaki Nomori
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yoshimoto, K.
Right arrow Articles by Kobayashi, T.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Yoshimoto, K.
Right arrow Articles by Kobayashi, T.
Related Collections
Right arrow Lung - cancer
Right arrow Lung - basic science

J Thorac Cardiovasc Surg 2009;137:1200-1205
© 2009 The American Association for Thoracic Surgery


General Thoracic Surgery

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

Kentaro Yoshimoto, MDa, Hiroaki Nomori, MD, PhDa,*, Takeshi Mori, MD, PhDa, Hironori Kobayashi, MD, PhDa, Yasuomi Ohba, MDa, Hidekatsu Shibata, MDa, Kuniyuki Tashiro, MDb, Shinya Shiraishi, MD, PhDb, Toshiaki Kobayashi, MD, PhDc

a Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
b Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
c Department of Assistive Diagnostic Technology, National Cancer Center Hospital, Tokyo, Japan

Received for publication February 13, 2008; revisions received October 1, 2008; accepted for publication October 25, 2008.

* Address for reprints: Hiroaki Nomori, MD, PhD, Department of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. (Email: hnomori{at}qk9.so-net.ne.jp).

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 (FEV1) after segmentectomy were compared with the FEV1 after virtual lobectomy, which was calculated by SPECT/CT. The preoperative and postoperative FEV1 of each lobe that had undergone segmentectomy was measured by SPECT/CT.

Results: The mean percent of FEV1 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 FEV1 of each lobe that was undergoing segmentectomy was 0.51±0.21 L, segmentectomy could preserve 41% ± 24% of it. The FEV1 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 FEV1 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.



Abbreviations and Acronyms CT = computed tomography; DICOM = Digital Imaging and Communications in Medicine; FEV1 = forced expiratory volume in 1 second; LUL = left upper lobe; NSCLC = non–small cell lung cancer; RI = radioisotope; RLL = right lower lobe; RUL = right upper lobe; SPECT = single-photon-emission computed tomography








HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The American Association for Thoracic Surgery.