右上肺叶切除术后肺叶移位对术后肺功能的影响。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS General Thoracic and Cardiovascular Surgery Pub Date : 2024-10-01 Epub Date: 2024-03-26 DOI:10.1007/s11748-024-02019-9
Sanae Kuroda, Kenji Miura, Nahoko Shimizu, Yoshitaka Kitamura, Wataru Nishio
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引用次数: 0

摘要

目标:肺叶切除术后,肺叶偶尔会发生移位,称为 "肺叶移位"。然而,其益处,尤其是对术后肺功能的益处仍存在争议。本研究旨在测量肺叶移位对术后肺功能尤其是右上叶肺功能的影响:这项回顾性研究包括2012年至2021年期间的273名右上叶切除术患者(肺叶切除术组)和24名右上段切除术患者(段切除术组)。根据 Synapse Vincent® 图像,肺叶切除术组又进一步细分为:术后中叶支气管向头部偏移组(偏移组:176 例)和未偏移组(未偏移组:97 例)。为了确定肺叶偏移的原因,对几个因素进行了检查。分析并比较了三组患者术后实际 1 秒用力呼气容积(FEV1.0)与术后预测 FEV1.0 的比率:结果:与肺叶移位相关的因素包括年龄(P右上肺叶切除术后肺叶移位受形态学因素影响,可能对术后肺功能产生有益影响。
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The effect of lobar shifting following right upper lobectomy on postoperative pulmonary function.

Objectives: Lobes occasionally displace after lobectomy, referred to as "lobar shifting". However, the benefits, especially in postoperative pulmonary function, remain controversial. This study aimed to measure the effect of lobar shifting on postoperative pulmonary function especially in the right upper lobe.

Methods: This retrospective study includes 273 right upper lobectomy patients (lobectomy group) and 24 right upper segmentectomy patients (segmentectomy group) from 2012 to 2021. The lobectomy group was further subdivided based on their Synapse Vincent® image: with their postoperative middle lobe bronchus shifted toward the head (shift group: 176 cases) and without (non-shift group: 97 cases). Several factors were examined to determine the cause of lobar shifting. The rate of measured actual postoperative forced expiratory volume in 1 s (FEV1.0) to predicted postoperative FEV1.0 was analyzed and compared among the three groups.

Results: Factors that correlated with lobar shifting included age (p < 0.001), a relatively small middle lobe volume (p = 0.03), no adhesions (p < 0.001), and good upper/middle and middle/lower lobulation (p = 0.04, p = 0.02). The rate of measured actual postoperative FEV1.0 to predicted postoperative FEV1 for the shift, non-shift, and segmentectomy groups were 112.5%, 107.9%, and 103.1% (shift vs non-shift: p = 0.04, shift vs segmentectomy: p = 0.02, non-shift vs segmentectomy: p = 0.19).

Conclusions: Lobar shifting after right upper lobectomy is influenced by morphological factors and may have a beneficial impact on postoperative pulmonary function.

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来源期刊
General Thoracic and Cardiovascular Surgery
General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine
CiteScore
2.70
自引率
8.30%
发文量
142
期刊介绍: The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.
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