Postsurgical change in the tracheal bifurcation angle after upper lobectomy: radiographic evaluation.

RATIONALE AND

OBJECTIVES

The purpose of this study was to evaluate postsurgical changes in the tracheal bifurcation angle on chest radiographs after upper lobectomy and to determine whether bronchial repositioning after upper lobectomy mimics that in upper lobe collapse.

MATERIALS AND

METHODS

The authors selected 81 patients who had undergone upper lobectomy with complete mediastinal and subcarinal lymph node dissection and in whom chest radiographs had been obtained before operation and at four postoperative intervals. The interbronchial angle and the subcarinal angle were measured on the preoperative and postoperative radiographs and compared statistically.

RESULTS

The average interbronchial angle and subcarinal angle during any postoperative period were significantly smaller than those before lobectomy (P < .001). These average angles decreased gradually during the postoperative periods.

CONCLUSION

The tracheal bifurcation angle was decreased on follow-up chest radiographs in most patients who underwent upper lobectomy with mediastinal lymph node dissection. This finding may be useful for establishing a history of this surgical procedure on the basis of chest radiographs.