LUNG-FUNCTION AND PERFUSION AFTER BRONCHIAL AND PULMONARY ARTERIAL SLEEVE RESECTION

Between January 1985 and December 1991, six patients underwent arteria l and bronchial sleeve resections of the left upper lobe. Preoperative and postoperative spirometry, preoperative split pulmonary radionucli de ventilation/perfusion (V/Q) scans and postoperative bronchoscopy we re obtained in four patients. Postoperative serial digital vascular im ages (DVI) of the pulmonary artery were obtained in three patients and one patient had a postoperativ V/Q scan. For each patient the preoper ative and postoperative forced expiratory volume in Is (FEV,) were det ermined to assess the postoperative ventilatory recovery. At bronchosc opy all patients had a patent bronchial anastomosis. At postoperative DVI, in three patients, vascularization of the residual left lung was delayed and less intense compared with the non-operated right lung. Po stoperative V/Q scan, in one patient, showed reduced ventilation and p erfusion of the residual lung. Preoperative and postoperative FEV, of the four patients were 2688/1998 mi, 2154/1752 mi, 2618/2100 mi and 22 77/2015 mi. Operative mortality was zero. One patient had a postoperat ive atelectasis of the left lower lobe. In our series, ventilation and vascularization of the reimplanted and revascularized left lower lobe were reduced. But, in our opinion, the preserved residual lung parenc hyma was still a relevant advantage.