298P - Does trisegmentectomy have functional benefit over lobectomy? Comparative analysis of changes in lung function and volumetry among stage IA non-small cell lung cancer patients

Background

It was still controversial regarding the postoperative preservation of pulmonary function after segmentectomy over lobectomy. In particular, resection for three or more segment was associated with more profound decreased in lung function. The purpose of this study was to investigate the effect of left upper division (LUD) segmentectomy on postoperative pulmonary function and lung volume comparison of left upper lobectomy among clinical stage IA non-small cell lung cancer (NSCLC).

Methods

Among clinical stage IA NSCLC patients who underwent LUD segmentectomy or left upper lobectomy between 2013 and 2018, postoperative changes in pulmonary function, 3-dimensional computed tomography (CT) volumetry and the percentage of low attenuation areas (% LAAs) were retrospectively reviewed according to surgical procedure. Changes in pulmonary function by groups were compared using linear mixed model with linear spline, random intercepts and slope.

Results

A total of 264 patient were identified, the study group consisted with 85 LUD segmentectomy (32.2%) and 179 left lobectomy (67.8%). In the adjusted model, no significant difference was observed among changes in pulmonary function by surgical procedure. In terms of lung volume, postoperative volume in contralateral lung and LLL was increased in both groups, it is more likely to have greater increase in LLL volume in lobectomy group (333.4 vs. 451.6 ml, p<0.001) than those in segmentectomy group. After surgery, the % LAA of left lung and LLL in the lobectomy group significantly increased compared to those in the segmentectomy group (0.37 vs. 1.31, p=0.002; 0.53 vs. 1.82, p<0.001), while change of % LAA of right lung was not significantly differ by surgical procedure. In the linear regression model, changes in lung volume and % LAA in left lung and LLL was significantly associated with type of surgery.

Conclusions

Postoperative changes in pulmonary function after LUD segmentectomy and left upper lobectomy was not significantly different. However, segmentectomy was significantly associated with less volume expansion and less increased % LAA compared with those in lobectomy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.