Functional results of bronchial sleeve lobectomy

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Abstract
The primary purpose of this study was to evaluate whether preservationof lung function parallels preservation of anatomy following electivebronchial sleeve-lobectomy (BSL). Between January 1984 and July 1988, 21male patients (median age 51 years) with non-small cell lung cancer (n =18), atypical carcinoid (n = 2) and inflammatory stenosis (n = 1) enteredthe study. Pulmonary function tests were performed pre- and postoperatively(at 3 and 12 months) and included spirometry, a quantitative perfusion lungscan and arterial blood gas analysis. The majority of operations wereperformed on the right lung (n = 15, 71%), with no operative deaths ormajor complications. Three months after surgery, the values of PaO2, PaCO2and overall perfusion improved significantly (P less than 0.05), whilethere was a non significant improvement of the forced vital capacity (FVC)and forced expiratory volume in 1 s (FEV1). The only parameter correlating(r = 0.46) and significantly (p = 0.032) predicting outcome after resectionwas overall perfusion. The preserved, reimplanted lobe rather thancontralateral lobe(s) significantly (p = 0.014) contributed to remainingoverall function. In 16 patients examined 12 months post- operatively afurther improvement in pulmonary function occurred. The data presenteddemonstrate that preservation of pulmonary function parallels preservationof anatomy following BSL and that the functional contribution ofreimplanted, ipsilateral lobe(s) is of paramount importance.

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