Nonaka M, Kadokura M, Tanio N, Yamamoto S, Kataoka D, Inoue K, Takaba T
First Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
Surg Today. 1998;28(3):285-8. doi: 10.1007/s005950050122.
To explore the anatomical repositioning of the middle lobe following right upper (RU) lobectomy, we measured the lobar volumes of the lung and the branching angles of the airway, and defined their changes after RU lobectomy in a rabbit model. Groups A1 (n = 10) and A2 (n = 10) were control groups and groups B1 (n = 10) and B2 (n = 10) underwent RU lobectomy. Casting material was introduced into the airway and a heart-lung bloc was removed form the thoracic cavity in all groups. In groups A1 and B1, the volume of each lobe of the bilateral lungs was measured, while in groups A2 and B2, bronchial casts were made and the branching angles of the airway were measured. The volume ratio of the right upper lobe (RUL) to the total lung was 12.0 +/- 0.4% in group A1; however, after RU lobectomy, the volume ratio of the right middle lobe (RML) to the total lung increased from 8.7 +/- 0.6% in group A1 to 13.5 +/- 0.8% in group B1. The volume of the left lung also increased from 43.0 +/- 0.5% in group A1 to 48.8 +/- 1.1% in group B1. The angle between the truncus intermedius and the RML bronchus was significantly smaller in group B2, at 109.0 +/- 3.5 degrees, than in group A2, in which it was 138.5 +/- 1.7 degrees. The angle between the RML bronchus and the coronal plane was 57.5 +/- 2.5 degrees in group A2 and 33.5 +/- 3.3 degrees in group B2. Our method of measuring the bronchial branching angle subsequent to RU lobectomy proved useful to illustrate postoperative positional changes and expansion of the remaining lobes.
为了探究右上叶(RU)切除术后中叶的解剖学重新定位,我们测量了肺叶体积和气道分支角度,并在兔模型中确定了RU切除术后它们的变化。A1组(n = 10)和A2组(n = 10)为对照组,B1组(n = 10)和B2组(n = 10)接受RU切除术。所有组均将铸型材料注入气道并从胸腔取出心肺块。在A1组和B1组中,测量双侧肺各叶的体积,而在A2组和B2组中,制作支气管铸型并测量气道分支角度。A1组右上叶(RUL)与全肺的体积比为12.0±0.4%;然而,RU切除术后,右中叶(RML)与全肺的体积比从A1组的8.7±0.6%增加到B1组的13.5±0.8%。左肺体积也从A1组的43.0±0.5%增加到B1组的48.8±1.1%。B2组中叶支气管与中间段支气管之间的角度明显小于A2组,分别为109.0±3.5度和138.5±1.7度。A2组中叶支气管与冠状面的角度为57.5±2.5度,B2组为33.5±3.3度。我们测量RU切除术后支气管分支角度的方法被证明有助于说明术后剩余肺叶的位置变化和扩张情况。