J Chest Surg.  2021 Dec;54(6):480-486. 10.5090/jcs.21.037.

Changes in Forced Expiratory Volume in 1 Second after Anatomical Lung Resection according to the Number of Segments

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
  • 2Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
  • 3Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea

Abstract

Background
Although various methods are already used to calculate predicted postoperative forced expiratory volume in 1 second (FEV₁) based on preoperative FEV₁ in lung surgery, the predicted postoperative FEV₁ is not always the same as the actual postoperative FEV₁. Observed postoperative FEV₁ values are usually the same or higher than the predicted postoperative FEV₁. To overcome this issue, we investigated the relationship between the number of resected lung segments and the discordance of preoperative and postoperative FEV₁ values.
Methods
From September 2014 to May 2020, the data of all patients who underwent anatomical lung resection by video-assisted thoracoscopic surgery (VATS) were gathered and analyzed retrospectively. We investigated the association between the number of resected segments and the differential FEV₁ (a measure of the discrepancy between the predicted and observed postoperative FEV₁ ) using the t-test and linear regression.
Results
Information on 238 patients who underwent VATS anatomical lung resection at Kyung Hee University Hospital at Gangdong and by DH. Kim for benign and malignant disease was collected. After applying the exclusion criteria, 114 patients were included in the final analysis. In the multiple linear regression model, the number of resected segments showed a positive correlation with the differential FEV₁ (Pearson r=0.384, p<0.001). After adjusting for multiple covariates, the differential FEV₁ increased by 0.048 (95% confidence interval, 0.023–0.073) with an increasing number of resected lung segments (R²=0.271, p<0.001).
Conclusion
In this study, after pulmonary resection, the number of resected segments showed a positive correlation with the differential FEV₁ .

Keyword

Video-assisted thoracoscopic surgery; Segmentectomy; Lobectomy; Respiratory function tests
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