Changes in pulmonary function in lung cancer patients after segmentectomy or lobectomy: a retrospective, non-intervention, observation study

Abstract

OBJECTIVES Pulmonary segmentectomy (SE) became an increasingly popular method for resection of early-stage lung cancer. This study aims to compare the impact of single SE (SSE), multiple SE (MSE) and lobectomy (LE) on postoperative pulmonary function (PF) in patients with non-small cell lung cancer (NSCLC). METHODS Medical records of a total of 1284 patients who underwent LE (n = 493), SSE (n = 558) and MSE (n = 233) at Shanghai Pulmonary Hospital from Jan 2013 to Oct, 2020 were retrospectively analyzed. Pulmonary function tests (PFT) were performed preoperatively and 12 months after surgery. RESULTS SSE was associated with a significantly smaller decline in the PFT values compared to MSE and LE. There was a poor consistency between the observed and expected (O/E) loss of pulmonary function in all study groups (p < 0.05). Both LE and SE resulted in similar O/E ratios of all PFT parameters (p > 0.05). CONCLUSION Overall loss of PF was much greater after LE than after both SSE and MSE. MSE was associated with higher postoperative PF decline compared to SSE but was still beneficial over LE. Both LE and SE groups had similar PFT loss per segment (p > 0.05).

Longitudinal changes in the volume of residual lung lobes after lobectomy for lung cancer: a retrospective cohort study

“…Based on existing reports regarding the impact of different types of lobectomy on lung function, except for the RML, there are no significant differences in the long-term effects on lung function parameters following resections of various lung lobes 6 , 7 , 9 . For this phenomenon, our study may provide a more detailed explanation.…”

“…Theoretically, the postoperative lung function of patients can be predicted using the number of functional lung segments removed, i.e., predicting postoperative FEV1 = preoperative FEV1 × (1 − the number of functional lung segments intended to be removed / total number of functional lung segments) 4 , 5 . But many studies have shown that this calculation method underestimates the patient’s long-term lung function 6 , 7 . These suggest that compensatory mechanisms play a crucial role in the postoperative recovery process for lung resection patients.…”

Lobectomy versus segmentectomy for stage IA3 (T1cN0M0) non-small cell lung cancer: a meta-analysis and systematic review

“…For NSCLC up to 2 cm, Bao et al. ( 30 ) and Ji et al. ( 29 ) reported that segmentectomy shows less loss of lung function than lobectomy.…”

Efficacy and safety of Traditional Chinese medicine in the treatment of pulmonary nodules: protocol for a systematic review and meta-analysis

“…Pulmonary nodule (PN) is a round or irregularly shaped lesion less than or equal to 3 centimeters in diameter in the lungs, which appears on imaging as a shadow of increased density, with clear or unclear borders, and may be single or multiple [1] .With the advancement of computed tomography (CT) technology and the widespread implementation of screening programs targeting high-risk groups, including individuals susceptible to lung cancer, the detection of small pulmonary nodules has seen a signi cant surge in recent years [2] . Studies indicate that PN is detected in approximately one-third of individuals undergoing routine chest CT screening or diagnostic tests for various clinical purposes [3] .Compared to PN ,a speci c type known as ground glass nodules (GGN) carries a higher risk of malignancy and is closely associated with lung cancer [4] .Current treatment primarily involves surgical resection and subsequent monitoring [5,6] .High-risk nodules undergo a biopsy to ascertain their benign or malignant nature before surgical resection is considered.However, this approach may lead to complications such as pneumothorax, hemoptysis, and decreased lung function due to the removal of lung lobes [7] .Choosing between biopsy and surgery for non-cancerous nodules with medium to low risk can lead to excessive treatment, strain on healthcare resources,prolonged follow-ups,and increased mental stress,anxiety,and depression [8] .…”