Author of

• 11890

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  P2.19 - Poster Session 2 - Imaging (ID 180)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11901

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    P2.19-011 - Compensation of vital capacity of residual lobes after lung resection in patients with lung cancer (ID 2493)

    09:30 - 09:30  |  Author(s): M. Matsutani
    • Abstract

    Background
    Major lung resection may induce expansion of the remaining lung, accompanied by some gain in the function of this lung. Pulmonary function studies have been performed in thoracotomy patients mainly for the purpose of predicting postoperative morbidity and mortality. Lobectomy is the standard operative procedure for lung cancer. However, the impact of this compensatory response of the residual lobes remains unclear, because spirometry cannot evaluate pulmonary function of individual lobe as single units.

    Methods
    Thirty-one patients who underwent lobectomy were included in this study. They were consisted of 15 males and 16 females, and 67 years old in average. Surgical procedures were 30 lobectomies and 1 bilobectomy. Chest CT scans at inspiratory and expiratory levels were performed at the same time using 40-slice MDCT (Brilliance 40, Philips, Netherlands). Scan conditions were 120 kV, ≤ 250 mAs, 0.5 sec./rotation, 32x1.25 configuration, pitch 0.906, and 5 sec. scan time. We then calculated the volume of individual lobes using graphic workstation (Virtual Place Lexus 1.0, AZE, Japan). Voxels with -215 HU or less were regarded as the air in the lung. VC of each lobe (VCL) was calculated as lobar volume at the inspiratory level subtracted by lobar volume at the expiratory level. This CT volumetry was performed before and 1 year after surgery.

    Results
    VCLs of the residual lobes in the operated side were 1.01±0.47L before surgery, and significantly (p=0.0094) increased to 1.22±0.74L after surgery. There was 22.3±43.6% gain in VCL of the lobes in the operated side after surgery compared with that before surgery. However, there was no significant difference (p=0.7040) in VCLs of the lobes in the unoperated side between before (1.71±0.71L) and after (1.69±0.63L) surgery. The rate of compensatory response of VCL of the residual lobes in the operated side was significantly (p=0.0002) correlated with the percentage of the VCL of the resected lobes. Statistical analysis revealed that the rate of compensatory response (%) could be calculated as the ratio of VCL in resected lung (%) before surgery multiplied by the constant of 1.556.

    Conclusion
    The compensatory response in pulmonary function after lobectomy appeared to occur only in the lobes in the operated side. The rate of this functional gain was significantly correlated with the ratio of the VCL in the resected lobes. These data may provide more precise prediction of postoperative lung function in patients who underwent lung resection.