The effect of body mass index and inferior pulmonary ligament division on the residual lung expansion after right upper lobectomy: A retrospective cohort study in a single center
- VernacularTitle:体重指数及下肺韧带松解对右上肺切除术后余肺复张影响的单中心回顾性队列研究
- Author:
Guang MU
1
;
Wenhao ZHANG
1
;
Hongchang WANG
1
;
Yan GU
1
;
Chenghao FU
1
;
Wentao XUE
1
;
Shiyuan XIE
2
;
Tong WANG
2
;
Ke WEI
1
;
Yang XIA
1
;
Liang CHEN
1
;
Jun WANG
1
Author Information
1. Department of Thoracic Surgery, Jiangsu Provincial Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210000, P. R. China
2. School of Stomatology, Nanjing Medical University, Nanjing, 211166, P. R. China
- Publication Type:Journal Article
- Keywords:
Right upper lobectomy;
inferior pulmonary ligament division;
residual lung expansion;
postoperative residual cavity;
body mass index;
bronchus angle;
video-assisted thoracic surgery;
lung volume
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(02):261-266
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of releasing the lower pulmonary ligament on right residual lung expansion after right upper lobe resection under different body mass index (BMI) levels. Methods The clinical data of patients who underwent thoracoscopic right upper lobe resection in the First Affiliated Hospital with Nanjing Medical University from 2021 to 2022 were retrospectively analyzed. Patients were divided into a group A (17 kg/m2＜BMI≤23 kg/m2), a group B (23 kg/m2＜BMI≤29 kg/m2) and a group C (BMI＞29 kg/m2) according to BMI. The presence of residual cavity was judged by chest X-ray at 7-10 days after operation, the degree of compensation change of the right main bronchus angle was measured, and the changes in lung volume were determined by CT three-dimensional reconstruction. Results A total of 157 patients who underwent thoracoscopic right upper lobe resection were included, including 71 males and 86 females, with an average age of (59.7±11.2) years. There were 50 patients in the group A, 75 patients in the group B, and 32 patients in the group C. In the group A, compared with those without releasing the lower pulmonary ligament, patients with releasing had a lower incidence of postoperative residual cavity (P=0.016), greater changes in bronchus angle (P<0.001), and smaller changes in lung volume (P<0.001). In the group B and C, there was no significant effect of releasing the lower pulmonary ligament on postoperative residual cavity, bronchus angle, and lung volume changes (P>0.05). Conclusion For patients with thin and long body shape and low BMI, releasing the lower pulmonary ligament is helpful to promote the expansion of the residual lung after right upper lobe resection and reduce the occurrence of postoperative residual cavity in patients.
