PURPOSE: Lung cancer cases complicated with COPD are known as the high risk group in the operation, because they often suffer from severe postoperative complications. Generally, respiratory function, nutrition and activity of day life are deteriorated in the most of COPD patients. It is expected that if such preoperative poor condition is improved, postoperative complication should be decreased. Therefore, we organized Nutrition Rehabilitation Surgery Team (NRST) to improve the malnutrition, low activity and poor respiratory condition in the high risk group before the operation. We report the result of NRST.
METHODS: The subjects were the lung cancer cases complicating COPD who would receive the radical operation over lung segmentectomy. Sixteen cases were enrolled during eighteen months from October 2009, whereas sixty-seven lung cancer cases without COPD were not. Fourteen cases were male, and two were female. Age was varied 60 to 88 years old. All sixteen cases received nutritional advice and rehabilitation by each special staffs. Surgical staff prescribed the medicine for COPD such as Tiotropium. These activities were kept on until admission. Nutrition indicator, physical strength and respiratory function were evaluated in the beginning of NRST intervention and the point of admission. The incidence rate of surgical complication and hospital stay were compared between groups intervened with and without NRST.
RESULTS: Nutrition indicators of blood examination (prealbumin, cholinesterase, etc.) did not improve, but bodyweight increased. Physical strength did not change, whereas respiratory function of FEV1.0% improved significantly (68.2±7.9%→71.0±9.8%). The incidence of post operative complications and the duration of hospital stay did not differ between groups intervened with and without NRST.
CONCLUSIONS: Lung cancer cases complicated with COPD were intervened with NLST, and their bodyweight and respiratory function improve significantly at the point of admission. Consequently, NRST might make the postoperative course better for the lung cancer cases complicated with COPD.
CLINICAL IMPLICATIONS: To improve the preoperative poor condition shown in the lung cancer cases complicated with COPD makes the postoperative course good.
DISCLOSURE: The following authors have nothing to disclose: Yosuke Matsuura, Masanobu Watari
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