ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Postoperative Pulmonary Function and Structural Remodelling After Lobectomy in Patients With and Without Chronic Obstructive Pulmonary Disease.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Three-Dimensional Computed Tomography Metrics Reveal Divergent Functional-Structural Adaptation After Lobectomy in Chronic Obstructive Pulmonary Disease.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Reply to Singh et al.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesQuantitative assessment of lung structure provides insights beyond conventional postoperative function prediction. This study examined how preoperative chronic obstructive pulmonary disease (COPD) status and emphysema distribution influence postoperative pulmonary function and structural remodelling using 3-dimensional computed tomography (3D-CT) cluster analysis.
methodsWe retrospectively analysed 426 lobectomy cases performed between 2018 and 2023. Patients were stratified into the COPD and non-COPD groups. Predicted postoperative FEV1.0 was estimated using 3D-CT volumetry, and the measured-to-predicted FEV1.0 ratio (MPFR) was calculated. Structural parameters, including D-value (reflecting alveolar complexity) and low-attenuation area (LAA), were measured pre- and postoperatively using 3D-CT. MPFR, % change in D-value (%D-value), and LAA (%LAA) were compared between the groups using Mann-Whitney U tests. Subgroup analysis was performed based on whether the resected lobe had a higher or lower D-value than the whole lung.
resultsPatients with COPD exhibited a significantly higher MPFR than those without COPD (117.9% vs 110.7%, P < .001). %D-value did not differ significantly between the groups (99.7% vs 98.1%, P = .476), whereas %LAA was significantly higher in non-COPD patients (134.9% vs 117.6%, P = .005). In subgroup analyses according to the presence of emphysematous resected lobes, MPFR and %D-value did not differ between the groups, and no significant difference in %LAA was observed.
conclusionsPatients with COPD maintain better-than-predicted postoperative function without additional structural loss, whereas non-COPD patients show volume-driven increases in LAA. Integrating functional and structural 3D-CT indexes-MPFR, D-value, and LAA-enables a comprehensive evaluation of postoperative lung remodelling, potentially improving risk stratification and surgical planning. CLINICAL REGISTRATION NUMBER: G-441; approved on May 12, 2025.
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