Quantification of the impact of segmentectomy on pulmonary function by perfusion single-photon-emission computed tomography and multidetector computed tomography
Received 13 February 2008; received in revised form 1 October 2008; accepted 25 October 2008.
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.
aDepartment of Thoracic Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
bDepartment of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
cDepartment of Assistive Diagnostic Technology, National Cancer Center Hospital, Tokyo, Japan
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.
ABSTRACT