Early hilar lung cancer is defined as localized cancer situated proximal to the segmental bronchus without nodal involvement or distant metastases. Patients with early hilar lung cancer are the most suitable candidates for bronchoplastic

WATANABE, Y., ODA, M., SHIMIZU, J., HAYASHI, Y., OHTA, Y., IWA, T., TONAMI, N. and HISADA, K. Functional Advantage of Parenchymal-Sparing Surgery for Early Hilar Lung Cancer. Tohoku J. Exp. Med., 1991, 163 (2), 135148 In a group of 27 patients with early hilar lung cancer, standard sleeve lobectomy was performed in 14 cases, standard lobectomy in 9 cases, and another 4 patients underwent parenchymal-sparing operations (2 had sleeve segmentectomy, 1 had sleeve middle lobectomy, and 1 had left second carinal resection). The changes of conventional pulmonary function tests and regional pulmonary function were compared between patients undergoing sleeve lobectomy and those undergoing parenchymal-sparing surgery. The parameters used for the conventional lung function tests were FVC, %FVC, FEVI o, and %FEVI o. For the evaluation of regional pulmonary function, perfusion scans using 99mTc-MAA and ventilation scans using 133Xe were performed. The decrease of FVC in the sleeve lobectomy group (n = 5) was 724± 182.7 ml, whereas that in the parenchymalsparing surgery group (n=4) was 367.5±52.1 ml, a significant difference. Both the FEVI .o and %FEVI,o showed no marked changes in both groups between the preoperative and postoperative values. Perfusion and ventilation scans in the parenchymal-sparing group showed a superior result in comparison with sleeve lobectomy group. All the patients undergoing parenchymalsparing operations survived over the long term. It was thus concluded that parenchymal-sparing surgery can be applied to carefully selected patients with tiny localized cancers. early hilar lung cancer ; parenchymal-sparing surgery ; sleeve segmentectomy ; conventional pulmonary function tests ; pulmonary scan