Anatomometric characteristics and pleural cavity changes after pneumonectomy

OBJECTIVE To analyze the anatomometric characteristics of post-pneumonectomy cavity and their changes at various times after surgery. MATERIAL AND METHODS The study included 47 patients aged 39-75 years after pneumonectomy (right-sided - 23 cases, left-sided - 24 cases). Computed tomography was performed prior to surgery, in 10-12 days, 6 and 12 months after intervention. Transverse, anteroposterior dimensions, height and volume of pleural cavity were evaluated using CT scans and 3D models. RESULTS Post-pneumonectomy cavity decreases and changes own shape in postoperative period. Reduction is mainly caused by decrease in its height. The volume of post-pneumonectomy cavity was decreased in early postoperative period by 1.8 times compared to preoperative values (from 3351.5±150.0 cm3 to 2112.1±152.6 cm3 on the right side and from 2674.3±125.2 cm3 to 1460.1±84.1 cm3 on the left side). After 12 months, this value was reduced by 3.68 times compared to early postoperative period (714.3±100.7 cm3 on the right and 401.5±42.5 cm3 on the left). The shape changes consist of flattening and sinus depth reduction. Exudate density was similar throughout a year. The capsule was formed in 74.1% of patients after 12 months. There was no correlation between the cavity reduction and patient constitution. CONCLUSION Post-pneumonectomy cavity is a dynamically changing anatomical formation participating in the mechanisms of compensation for changes after pneumonectomy. The most significant collapse of post-pneumonectomy cavity occurs in early postoperative period. Cavity reduction degree does not depend on individual characteristics of patients.