Brusasco V, Ratto G B, Crimi P, Sacco A, Motta G
Cattedra di Semeiotica Chirurgica, Università di Genova, Italy.
Scand J Thorac Cardiovasc Surg. 1988;22(1):73-8. doi: 10.3109/14017438809106055.
Eight patients who underwent upper sleeve lobectomy and six who underwent upper simple lobectomy for lung cancer were studied. The two groups were matched for age and preoperative lung function as assessed by standard spirometry. Post-operative lung function studies, including measurements of regional ventilation (Vr) and perfusion (Qr) by 133 Xenon technique showed that: 1) two weeks after surgery, forced expiratory volume at 1 s was more reduced after simple than after sleeve lobectomy, but in both groups Vr and its vertical gradient were similarly reduced in the operated lung compared to the contralateral; 2) one year after sleeve lobectomy, the vertical gradient of Vr tended to disappear in both lungs while Vr and Vr/Qr of the operated side increased significantly. These results indicate that early after surgery lung function may be less impaired after sleeve than simple lobectomy; however, long-term changes of regional lung function may occur after sleeve lobectomy resulting into a high Vr/Qr ratio in the operated lung.
对8例行肺上叶袖状切除术和6例行肺上叶单纯切除术的肺癌患者进行了研究。两组患者在年龄和通过标准肺量计评估的术前肺功能方面进行了匹配。术后肺功能研究,包括通过133氙技术测量区域通气(Vr)和灌注(Qr),结果显示:1)术后两周,单纯肺叶切除术后1秒用力呼气量的降低幅度大于袖状肺叶切除术,但与对侧相比,两组手术侧肺的Vr及其垂直梯度均有类似程度的降低;2)袖状肺叶切除术后一年,两侧肺的Vr垂直梯度均趋于消失,而手术侧的Vr和Vr/Qr显著增加。这些结果表明,术后早期袖状肺叶切除术对肺功能的损害可能小于单纯肺叶切除术;然而,袖状肺叶切除术后区域肺功能可能会发生长期变化,导致手术侧肺的Vr/Qr比值升高。