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Assessment of Pulmonary Function after Right Upper Lobectomy in Patients with Lung Cancer: Does Right Upper Lobectomy Compomise Pulmonary Function? FREE TO VIEW

Keiji Kushibe, MD*; Makoto Takahama, MD; Takeshi Kawagichi, MD; Yamato Tamura, MD; Tomoaki Hirose, MD; Shigeki Taniguchi, MD
Author and Funding Information

Nara Medical Un, Kashihara, Japan


Chest


Chest. 2004;126(4_MeetingAbstracts):741S. doi:10.1378/chest.126.4_MeetingAbstracts.741S-b
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Abstract

PURPOSE:  Volume reduction surgery is a useful method improving pulmonary function by resection of the lung with severe emphysematous changes. As patients with lung cancer somewhat have emphysematous changes, we assumed that lobectomy provided volume reduction effects. Some previous studies reported that patients with emphysematous changes predominantly in the upper lobe had good volume reduction effects in volume reduction surgery. We assumed that the right upper lobe might be a site generating most volume reduction effects after lobectomy. We assessed pulmonary function after right lobectomy regarding volume reduction effects by lobectomy.

METHODS:  Forty-three patients with NSCLC underwent pulmonary function test preoperatively and at 6 to 12 months after right upper lobectomy. Of the patients, 31 underwent perfusion scan preoperatively.

RESULTS:  The percent change in FEV1.0 after surgery was -6.9 ± 16.1%. There was a significant relationship between the percent change in FEV1.0 after surgery and preoperative FEV1.0 (or preoperative %FEV1.0). Correlation coefficients were r=-0.702, p<0.001 for preoperative FEV1.0, and r=-0.667, p<0.001 for preoperative % FEV1.0. For all patients who had a value of preoperative FEV1.0 less than 1.5l (or preoperative %FEV1.0 less than 60%), FEV1.0 increased postoperatively (n=9). In the assessment by preoperative perfusion scan (n=31), there was no significant relationship between the percent perfusion to the upper lobe and the percent change in FEV1.0 after surgery. However, for patients who had a value of preoperative FEV1.0 less than 1.5l (n=9), there was a significant relationship between these variables (r=0.671, p<0.05).

CONCLUSION:  Patients with a lower preoperative FEV1.0 had a lower percent change in FEV1.0 after right upper lobectomy. In patients who had a value of preoperative FEV1.0 less than 1.5l, the patients with lower perfusion for right upper lobe had a higher percent change in FEV1.0 after lobectomy.

CLINICAL IMPLICATIONS:  As patients with a value of preoperative FEV1.0 less than 1.5l had more volume reduction effects by lobectomy after right upper lobectomy, they are likely to have an increase in FEV1.0 postoperatively.

DISCLOSURE:  K. Kushibe, None.

Tuesday, October 26, 2004

10:30 AM- 12:00 PM


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