초록접수 현황
| 20F-155 | 구연 발표 |
Three-dimensional analysis of volumetric changes after segmentectomy in comparison of lobectomy
Ha Eun Kim, Young Ho Yang, Byung Jo Park, Seong Yong Park, Jin Gu Lee, Dae Joon Kim, Hyo Chae Paik, Chang Young Lee
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : Preservation of pulmonary function and residual lung volume after segmentectomy by reducing the extent of resection is well described, however, the volumetric changes and compensation patterns of preserved lungs after segmentectomies are still unknown. We analyzed pre and postoperative lung volumes after pulmonary resections.
Methods : 342 patients undergoing lobectomy(n=245) and segmentectomy(n=97) from October 2018 to February 2020 were reviewed retrospectively. Chest CT scan was performed before, 2month and 6month after resection. The ipsilateral residual and nonoperatated lobe volumes and the contralateral lobe volumes were calculated using three-dimensional CT-volume analyzer. The percent change is calculated the relative changes for each case.
Results : The planned resection volume was 364.3ml(11.1%) and the predicted residual volume was 592.8ml(13.6%) in segmentectomy. The actual residual volumes were 603.3ml(15.6%) at 2 month, 659.8ml(14.5%) at 6months and the mean percent change was 22.8% at 2month, 10.4% at 6 month after segmentectomy. The largest residual expansion was notable in left lower lobe(LLL) segmentectomy(71.9%) at postoperative 2month. The ipsilateral residual lobes were more extensively expanded in both. After right upper lobe segmentectomy, right lower lobe(RLL) was the most compensating requisite(9.7%) likewise after lobectomy(22.5%). Right middle lobe was expanded most significantly after RLL resection(segmentectomy, 11.7%; lobectomy, 12.9%). For LLL segmentectomy, RLL compensated the volume more than the ipsilateral lungs(17.6%), whereas the ipsilateral lungs enlarged greatly in left side lobectomy.
Conclusion : Volumetric compensation after segmentectomy is mainly induced by the ipsilateral lungs except LLL. These compensatory patterns can be employed to resections for compromised pulmonary reservoir and repeated resections
Methods : 342 patients undergoing lobectomy(n=245) and segmentectomy(n=97) from October 2018 to February 2020 were reviewed retrospectively. Chest CT scan was performed before, 2month and 6month after resection. The ipsilateral residual and nonoperatated lobe volumes and the contralateral lobe volumes were calculated using three-dimensional CT-volume analyzer. The percent change is calculated the relative changes for each case.
Results : The planned resection volume was 364.3ml(11.1%) and the predicted residual volume was 592.8ml(13.6%) in segmentectomy. The actual residual volumes were 603.3ml(15.6%) at 2 month, 659.8ml(14.5%) at 6months and the mean percent change was 22.8% at 2month, 10.4% at 6 month after segmentectomy. The largest residual expansion was notable in left lower lobe(LLL) segmentectomy(71.9%) at postoperative 2month. The ipsilateral residual lobes were more extensively expanded in both. After right upper lobe segmentectomy, right lower lobe(RLL) was the most compensating requisite(9.7%) likewise after lobectomy(22.5%). Right middle lobe was expanded most significantly after RLL resection(segmentectomy, 11.7%; lobectomy, 12.9%). For LLL segmentectomy, RLL compensated the volume more than the ipsilateral lungs(17.6%), whereas the ipsilateral lungs enlarged greatly in left side lobectomy.
Conclusion : Volumetric compensation after segmentectomy is mainly induced by the ipsilateral lungs except LLL. These compensatory patterns can be employed to resections for compromised pulmonary reservoir and repeated resections
책임저자: Chang Yong Lee
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Ha Eun Kim, E-mail : gracehn@yuhs.ac