@article{QIMS154062,
author = {Go Kamimura and Koji Takumi and Masaya Aoki and Satomi Imamura and Yuto Nonaka and Tadashi Umehara and Aya Takeda and Koki Maeda and Toshiyuki Nagata and Kazuhiro Ueda},
title = {Postoperative lung geometric repositioning after right upper lobectomy: the role of thoracic morphology configuration},
journal = {Quantitative Imaging in Medicine and Surgery},
volume = {16},
number = {7},
year = {2026},
keywords = {},
abstract = {Background: Right upper lobectomy (RUL) is the most frequently performed lobectomy for lung cancer, yet postoperative functional loss varies widely among patients. We hypothesized that thoracic morphology constrains three-dimensional (3D) repositioning of the residual lung after RUL, leading to characteristic bronchial axis deviation and rotation-like deformation, and that these geometric changes might be associated with postoperative residual-lobe expansion.Methods: We retrospectively analyzed 26 patients who underwent RUL (2016–2018), including five with middle lobe atelectasis (MLA). Paired pre- and postoperative computed tomography was used to quantify residual-lobe volumes and geometric markers (thoracic morphology, sagittal bronchial axis deviation of B4/5 and B6, and plane-based rotation-like deformation) and to test their associations with repositioning patterns and postoperative expansion.Results: Two distinct residual-lung repositioning patterns were identified: a B6-dominant pattern, in which the superior segment (S6) ascended to occupy the postoperative apical space (Type B6), and a B4/5-dominant pattern, in which the middle lobe migrated cranially (Type B4/5). Type B6 was associated with barrel-shaped thoraces, whereas Type B4/5 was associated with flatter thoraces [thoracic height-to-anteroposterior diameter (H/AP) ratio, P=0.001; 8th-rib angle, P},
issn = {2223-4306}, url = {https://qims.amegroups.org/article/view/154062}
}