The effect of postoperative change in bronchial angle on postoperative pulmonary function after upper lobectomy in lung cancer patients

Abstract

Although the change in the bronchial angle is a physiological condition, it can reduce postoperative pulmonary function. The measurement of the change in the angle using the coronal view of a chest CT is a useful screening tool for predicting the postoperative reduction in FEV1.

Changes in Pulmonary Function in Lung Cancer Patients After Video-Assisted Thoracic Surgery

“…Therefore, the expansion of the remaining lobe could compensate for the resected lobe over the course of time. However, as we previously reported [26], after lobectomy of the RUL or RML, upward displacement of the RLL caused an angulation of the right bronchus intermedius. This phenomenon led to increased airway resistance and disturbed the recovery of FEV 1 .…”

“…Lobectomy inevitably leads to displacement of the remaining lobe. Such displacement could cause bronchial angulation, a narrowed airway, and increased airway resistance [26]. As FEV 1 is an indicator of airway resistance, the VATS lobectomy group did not show greater improvements in FEV 1 [18].…”

Pleural Hypercarbia After Lung Surgery Is Associated With Persistent Alveolopleural Fistulae

“…2,8 Following upper lobectomy, the lower lobe bronchus migrates upward, making a steeper angle between the main bronchus and the lower lobe bronchus. 27,28 Moreover, after right upper lobectomy, the longer and narrower middle lobe bronchus must pass inferior and medial to the interlobar pulmonary artery before turning 180 degrees to ascend to the apex of the hemithorax. This action would provide more airflow resistance, leading to decreased regional ventilation and higher alveolar CO 2 .…”

Traitement des cancers du poumon de stade I : la radiothérapie en conditions stéréotaxiques devient-elle un nouveau standard ? Point de vue d’un chirurgien

“…À droite, le volume du lobe supérieur ou du lobe moyen est plus petit que celui du lobe inférieur. Après lobectomie supérieure cependant, l'angulation du tronc bronchique intermédiaire que produit l'adaptation contenant/contenu augmente la résistance des voies aériennes [27]. Du fait que les lobes inférieurs sont de gros volume, leur ablation de fait entraîne une réduction de la capacité vitale forcée (CVF) et de la DLCO bien supérieure à ce que l'on observera après résection infralobaire.…”