P3.04-010 Changes of Right Lung Volume after Right Upper Lobectomy for Lung Cancer: Topic: Miscellaneous I

Abstract

Many surgeons routinely perform the division of the inferior pulmonary ligament (IPL) during the right upper lobectomy for lung cancer. It is believed that the division of the IPL can facilitate mobilizing and expanding residual lobes, and decreasing dead space. We aimed to evaluate the volume changes of the right middle lobe (RML) and the right lower lobe (RLL) after right upper lobectomy according to IPL division. We performed a retrospective analysis of the medical records and images of 181 patients with lung cancer who had underwent right upper lobectomy via a video-assisted thoracic surgery (VATS) in Seoul Asian Medical Center from May 2009 to December 2013. The IPL was preserved in 76 patients (Group A) and was divided in 105 patients (Group B). Using in-house software with chest computed tomography (CT), we compared the difference volume changes of pre- and post-operative RML and RLL between the two groups. There were no significant differences between the two groups in terms of age, sex, height, tumor size, chronic obstructive pulmonary disease and smoking status. In group A, the adjusted mean volume change of difference RML (dRML) and difference RLL (dRLL) were -0.45 mL/kg and 6.03 mL/kg, respectively. In group B, the adjusted mean volume change of dRML and dRLL were -0.55 mL/kg and 5.28 mL/kg, respectively. The difference was not significant. Division of the IPL during the right upper lobectomy is not beneficial technique regarding remnant lung volume.