Postoperative Geometric Adaptation of the Residual Lung: From Three-Dimensional Repositioning to Bronchial Deformation and Functional Outcome

Following anatomical lung resection, the residual pulmonary parenchyma undergoes a complex process of three-dimensional adaptation within the thoracic cavity. Remaining lobes rotate, expand, and shift to fill the space left by resected tissue, while the diaphragm, mediastinum, and chest wall reposition to compensate for the new intrathoracic volume. These geometric changes are not purely mechanical: they can distort the bronchial tree, alter airway angles, and compress or kink residual bronchi, potentially affecting ventilation, mucus clearance, and long-term pulmonary function. Despite growing recognition that postoperative lung remodeling influences functional recovery, the relationship between three-dimensional anatomical repositioning and clinical outcome remains incompletely characterized, and current surgical planning rarely accounts for it explicitly.Advances in volumetric CT reconstruction, image registration, and computational modeling now make it possible to quantify residual lung repositioning and bronchial deformation with a precision that was not previously achievable. These tools open the door to a more predictive, patient-specific approach to thoracic surgery — one in which the expected geometric consequences of a given resection pattern can be modeled preoperatively and monitored postoperatively, informing both surgical technique and rehabilitation strategy.This Research Topic welcomes original research, clinical studies, and reviews addressing the structural and functional consequences of lung resection, including but not limited to:• Three-dimensional imaging and modeling of residual lung repositioning after lobectomy, segmentectomy, or pneumonectomy • Quantitative assessment of bronchial axis deviation, rotation-like deformation, or kinking following lung resection • Correlation between postoperative anatomical remodeling and pulmonary function test outcomes • Computational and biomechanical models of thoracic cavity adaptation • Impact of surgical technique (open, VATS, robotic) on residual lung geometry • Long-term functional and quality-of-life outcomes related to postoperative lung remodeling • Use of preoperative simulation or 3D printing to predict postoperative anatomical changes • Strategies to mitigate adverse bronchial deformation and optimize residual lung functionBy bringing together thoracic surgeons, radiologists, pulmonologists, and biomedical engineers, this Research Topic aims to advance understanding of how the lung adapts geometrically after resection and how this knowledge can be translated into better surgical planning, improved functional outcomes, and more personalized postoperative care. Topic editors: Go Kamimura, Giuseppe Aresu Source: https://www.frontiersin.org/research-topics/86730/postoperative-geometric-adaptation-of-the-residual-lung-from-three-dimensional-repositioning-to-bronchial-deformation-and-functional-outcome