Kakeda Shingo, Kamada Koji, Aoki Takatoshi, Watanabe Hideyuki, Nakata Hajime
Department of Radiology, University of Occupational and Environmental Health School of Medicine, Iseigaoka 1-1, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan.
Acad Radiol. 2003 Jun;10(6):644-9. doi: 10.1016/s1076-6332(03)80083-1.
The purpose of this study was to evaluate postsurgical changes in the tracheal bifurcation angle on chest radiographs after upper lobectomy and to determine whether bronchial repositioning after upper lobectomy mimics that in upper lobe collapse.
The authors selected 81 patients who had undergone upper lobectomy with complete mediastinal and subcarinal lymph node dissection and in whom chest radiographs had been obtained before operation and at four postoperative intervals. The interbronchial angle and the subcarinal angle were measured on the preoperative and postoperative radiographs and compared statistically.
The average interbronchial angle and subcarinal angle during any postoperative period were significantly smaller than those before lobectomy (P < .001). These average angles decreased gradually during the postoperative periods.
The tracheal bifurcation angle was decreased on follow-up chest radiographs in most patients who underwent upper lobectomy with mediastinal lymph node dissection. This finding may be useful for establishing a history of this surgical procedure on the basis of chest radiographs.
本研究旨在评估上叶切除术后胸部X线片上气管分叉角度的术后变化,并确定上叶切除术后支气管重新定位是否与上叶肺不张中的情况相似。
作者选取了81例行上叶切除术并进行完整纵隔及隆突下淋巴结清扫的患者,这些患者术前及术后四个时间点均有胸部X线片。在术前及术后X线片上测量支气管间角度和隆突下角度,并进行统计学比较。
术后任何时期的平均支气管间角度和隆突下角度均显著小于肺叶切除术前(P <.001)。这些平均角度在术后各时期逐渐减小。
大多数接受纵隔淋巴结清扫的上叶切除术患者,随访胸部X线片显示气管分叉角度减小。这一发现可能有助于根据胸部X线片确定该手术史。