Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars. Pulmonary function tests were performed a week before surgery and 3 months after surgery. There were 14 males and 11 females in VATS lobectomy and 32 males and 30 females in mini-thoracotomy lobectomy. For lobe location (right upper/right lower/left upper/left lower), there were 12/1/8/4 in VATS lobectomy and 16/19/13/14 in mini-thoracotomy lobectomy, respectively. The percent predicted postoperative forced vital capacity (FVC) (postoperative FVC/predicted postoperative FVC × 100) (110 ± 15 %) of VATS lobectomy was significantly higher than that (101 ± 16 %) of mini-thoracotomy lobectomy ( = 0.0124). The percent predicted postoperative forced expiratory volume in 1 s (FEV1) (postoperative FEV1/predicted postoperative FEV1 × 100) (110 ± 15 %) of VATS lobectomy was not significantly higher than that (104 ± 15 %) of mini-thoracotomy lobectomy ( = 0.091). Multiple regression analysis revealed that operative procedure (VATS lobectomy or mini-thoracotomy lobectomy) was the only significant variable contributing to percent predicted postoperative FVC ( = 0.0073) and percent predicted postoperative FEV1 ( = 0.0180). Postoperative FVC after VATS lobectomy is better than after mini-thoracotomy lobectomy.
Background: Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer. Methods: A total of 36 lung cancer patients with recurrence or metastasis were enrolled in this study. While 16 patients underwent magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography-computed tomography (PET-CT), 17 underwent MRI and CT, and 3 underwent MRI and PET-CT. Results: Each recurrence or metastasis showed decreased diffusion, which was easily recognized in DWI. The detection rate for recurrence or metastasis was 100% (36/36) in DWI, 89% (17/19) in PET-CT and 82% (27/33) in CT. Detection rate of DWI was significantly higher than that of CT (p=0.0244) but not significantly higher than that of PET-CT (p=0.22). When the optimal cutoff value of the apparent diffusion coefficient value was set as 1.70×10 -3 mm 2 /sec, the sensitivity of DWI for diagnosing recurrence or metastasis of lung cancer was 95.6%. Conclusions: DWI is useful for detection of recurrence and metastasis of lung cancer.
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