Exercise capacity may be reduced in patients with COPD. We evaluated patients with COPD who underwent lung cancer reduction in order to examine how surgery influences pulmonary function and exercise capacity.
We studied 13 patients (2 F; age range: 51 to 74 yr) with moderate to severe COPD and lung cancer. Before and after surgery, FEV1, FEV1/VC, TLC, and TLCO were recordered. Exercise capacity was also assessed by an incremental symptom limited exercise test on cycle ergometer. O2 uptake at peak of exercise (V’O2max) and at anaerobic threshold (V’O2@AT) values were recordered. Via standard posterolateral thoracotomy patients underwent lobectomy or bilobectomy according to lung cancer extension.
Before surgery mean±SD values of FEV1, FEV1/VC, TLC, and TLCO were 47% of pred±18, 46%±14, 129% of pred±37, and 72% of pred ±39, respectively. O2 uptake at peak of exercise (V’O2max) and at anaerobic threshold (V’O2@AT) values were 1,337mL/min±353 and 1,010mL/min±235, SpO2 fall value during exercise was 2.4%±3. After 109days±39 from surgery, FEV1, FEV1/VC, TLC, and TLCO values did not significantly differ (50%±19, 50%±15, 108%±23, and 57%±20). V’O2max value significantly decreased, as compared to that before surgery (987ml/min±219, p<0.05). In three patients, the AT was not detectable, in the remaining patients V’O2@AT value was significantly less that before surgery (797ml/min±155, p<0.05). SpO2 fall value did not change (3%±3).
In patients affected by lung cancer and moderate to severe COPD, lobectomy or bilobectomy can significantly affect the exercise capacity in spite of no significant changes in pulmonary function.
Both deconditioning and circulatory limitation may occur after surgery in patients with lung cancer and COPD.
A. Castagnaro, None.