Comparison of pulmonary function between sleeve lobectomy and standard lobectomy.

Abstract

Background: The extent of anastomotic stenosis after sleeve lobectomy (SL) remains unclear, and there are limited reports on postoperative pulmonary function. This study aimed to compare postoperative pulmonary function between SL and standard lobectomy (STL) and to evaluate anastomotic stenosis in SL.

Methods: This study included 44 SL patients and 825 STL patients from 2012 to 2023. Post- or preoperative forced expiratory volume in 1 s (FEV1.0) values (FEV1.0 preservation rate) were analyzed and compared between the SL and STL groups. The lobe expanded rate values, calculated using volumes of the lung lobe(s) distal to the bronchial anastomosis in the SL group and the corresponding lobe(s) in the STL group, measured using three-dimensional computed tomography (3D-CT), were analyzed and compared. In the SL group, the surface area of the lumen at the site corresponding to the bronchial anastomosis was measured on 3D-CT, and the postoperative/preoperative value (bronchus stenosis rate) was calculated.

Results: The SL and STL groups significantly differed in terms of the FEV1.0 preservation rate (84.6% vs. 87.7%, p = 0.180); however, the lobe expanded rate was significantly lower in the SL group (119.1% vs. 134.6% p = 0.009). The average bronchus stenosis rate was 64.3%, with no significant difference between wedge and circumferential bronchial resection groups (63.4% vs. 66.4%, p = 0.730).

Conclusion: The volume of the lung lobe(s) distal to the bronchial anastomosis after SL was lower than that after STL. However, this did not affect postoperative pulmonary function. The type of bronchoplasty did not influence the development of anastomotic stenosis.