Lung function and perfusion after bronchial and pulmonary arterial sleeve resection

Between January 1985 and December 1991, six patients underwent arterialand bronchial sleeve resections of the left upper lobe. Preoperative andpostoperative spirometry, preoperative split pulmonary radionuclideventilation/perfusion (V/Q) scans and postoperative bronchoscopy wereobtained in four patients. Postoperative serial digital vascular images(DVI) of the pulmonary artery were obtained in three patients and onepatient had a postoperative V/Q scan. For each patient the preoperative andpostoperative forced expiratory volume in is (FEV1) were determined toassess the postoperative ventilatory recovery. At bronchoscopy all patientshad a patent bronchial anastomosis. At postoperative DVI, in threepatients, vascularization of the residual left lung was delayed and lessintense compared with the non-operated right lung. Postoperative V/Q scan,in one patient, showed reduced ventilation and perfusion of the residuallung. Preoperative and postoperative FEV1 of the four patients were2688/1998 ml, 2154/1752 ml, 2618/2100 ml and 2277/2015 ml. Operativemortality was zero. One patient had a postoperative atelectasis of the leftlower lobe. In our series, ventilation and vascularization of thereimplanted and revascularized left lower lobe were reduced. But, in ouropinion, the preserved residual lung parenchyma was still a relevantadvantage.