Lung Expansion And Alternation Of Low Attenuation Volume In Lobectomized Patients

Introduction: Lung expansion after lobectomy is different according to the resected lobe (Sengul AT, et al. 2013). We have reported that the percent predicted diffusing capacity of the lung for carbon monoxide (%DLco) was improved from 3 to 12 months after single lobectomy in right upper and lower lobe lobectomy (from 98.71% to 106.83% and from 84.84% to 94.49%, respectively) (Yokoba M, et al. ERS 2017). However, it is still unclear that alternation of the emphysematous lung parenchyma of ipsi- and contralateral remained lobes according to resected lobe. Purpose and Methods: The aim of this study was to prospectively compare the alternation of volume and emphysematous lung volume (low attenuation volume (LAV) on CT image defined with -950HU) of remained lobes after lobectomy. (Ethics # B13-110). The volume and LAV of each lobe were measured preoperatively (po) and 12 months (12M) postoperatively in 56 patients underwent video-assisted thoracic surgery (VATS) lobectomy. Results: Lobectomy on right upper and lower lobe (RUL and RLL) and left upper and lower lobe (LUL and LLL) were 18, 5, 15 and 8 patients, respectively. In RUL and LUL lobectomy, larger remaining ipsilateral lung expansion and minor volume increasing of the contralateral lung was shown. Alteration of %LAV of the remained lobe between 12M and po were from -0.96 to 1.39%. Conclusion: We conclude that for single VATS lobectomy, 1-year improvement of %DLco might be related with remained lobe expansion, not alternation of LAV.