Pulmonary function after segmentectomy for small peripheral carcinoma of the lung

Objective: The aim of this study is to compare the pulmonary function after a segmentectomy with that after a lobectomy for small peripheral carcinoma of the lung. Patients and methods: Between 1993 and 1996, segmentectomy an d lobectomy were performed on 48 and 133 good-risk patients, respectively. Lymph node metastases were detected after the operation in 6 and 24 patient s of the segmentectomy and lobectomy groups, respectively, For bias reducti on in comparison with a nonrandomized control group, we paired 40 segmentec tomy patients with 40 lobectomy patients using nearest available matching m ethod on the estimated propensity score. Results: Twelve months after the o peration, the segmentectomy and lobectomy groups had forced vital capacitie s of 2.67 +/- 0.73 L (mean +/- standard deviation) and 2.57 +/- 0.59 L, whi ch were calculated to be 94.9% +/- 10.6% and 91.0% +/- 13.2% of the preoper ative values (P = .14), respectively, The segmentectomy and lobectomy group s had postoperative 1-second forced expiratory volumes of 1.99 +/- 0.63 L a nd 1.95 +/- 0.49 L, which were calculated to be 93.3% +/- 10.3% and 87.3% /- 14.0% of the preoperative values, respectively (P = .03). The multiple l inear regression analysis showed that the alternative of segmentectomy or l obectomy was not a determinant for postoperative forced vital capacity but did affect postoperative 1-second forced expiratory volume. Conclusion: Pul monary function after a segmentectomy for a good-risk patient is slightly b etter than that after a lobectomy, However, segmentectomy should be still t he surgical procedure for only poor-risk patients because of the difficulty in excluding patients with metastatic lymph nodes from the candidates for the procedure.