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Does Division of the Pulmonary Ligaments Affect the Outcomes after Thoracoscopic Lobectomy: A Retrospective Study of 72 Cases

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Background: Whether dissecting or not the inferior pulmonary ligaments (IPLs) during superior video-assisted thoracoscopic (VATS) lobectomy for early stage lung cancer remains controversial.

Objective: To evaluate the influence of dissecting the IPLs in VATS superior lobectomy on bronchial distortion and recovery of pulmonary function.

Methods: This was a retrospective study of 72 patients who underwent VATS superior lobectomy from March 2012 to August 2013 at the First People’s Hospital of Yunnan Province. Patients were grouped according to IPLs preservation (group P) or dissection (group D). The preoperative and postoperative pulmonary function and the postoperative complications were analyzed. The change in bronchi angles and pulmonary capacity were measured using computed tomography (CT).

Results: There was no significant difference in the complication rate and volume of chest drainage between the two groups. The change in bronchus angle in group P was significantly smaller than in group D after left lung operation (P=0.046 at 3 months; P=0.038 at 6 months). In the right lung, the angle change was greater in group D than in group P at 3 months (P=0.057) but not at 6 months (P=0.541). In terms of pulmonary function, the FEV2% and FEV1 were significantly better in group P than in group D at 3 and 6 months (P<0.05). The pulmonary capacity in group P was significantly larger than in group D at 6 months (P=0.002).

Conclusion: Preservation of IPLs during VATS lobectomy might have an impact on the bronchus angle, and lung function and volume.

07 Jan, 2016
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e-Published: 23 Mar, 2017


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