Functional advantage of parenchymal-sparing surgery for early hilar lung cancer.

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Abstract
WATANABE, Y., ODA, M., SHIMIZU, J., HAYASHI, Y., OHTA, Y., IWA, T., TONAMI, N. and HISADA, K. Functional Advantage of Parenchymal-Sparing Surgery for Early Hilar Lung Cancer. Tohoku J. Exp. Med., 1991, 163 (2), 135-148 - In a group of 27 patients with early hilar lung cancer, standard sleeve lobectomy was performed in 14 cases, standard lobectomy in 9 cases, and another 4 patients underwent parenchymal-sparing operations (2 had sleeve segmentectomy, 1 had sleeve middle lobectomy, and 1 had left second carinal resection). The changes of conventional pulmonary function tests and regional pulmonary function were compared between patients undergoing sleeve lobectomy and those undergoing parenchymal-sparing surgery. The parameters used for the conventional lung function tests were FVC, %FVC, FEV1.0, and %FEV1.0. For the evaluation of regional pulmonary function, perfusion scans using 99mTc-MAA and ventilation scans using 133Xe were performed. The decrease of FVC in the sleeve lobectomy group (n=5) was 724±182.7ml, whereas that in the parenchymal- sparing surgery group (n=4) was 367.5±52.1ml, a significant difference. Both the FEV1.0 and %FEV1.0 showed no marked changes in both groups between the preoperative and postoperative values. Perfusion and ventilation scans in the parenchymal-sparing group showed a superior result in comparison with sleeve lobectomy group. All the patients undergoing parenchymal-sparing operations survived over the long term. It was thus concluded that parenchymal-sparing surgery can be applied to carefully selected patients with tiny localized cancers.

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