PURPOSE: Earlier return to work after lung resection is very important for patients. We attempted to select patients for early return to work after lung resection.
METHODS: Between 1998 and 2007, surgery was performed on 208 patients (190 had lobectomy, 10 had bilobectomy, and 8 had pneumonectomy). There were 122 men and 86 women with a mean age of 68 years. Exercise testing and spirometric lung function testing were performed before surgery, and 2 and 4 weeks afterward. Exercise testing measured the maximum oxygen uptake per minute per body surface area (VO2max/m2). The rate of change of VO2max/m2 in weeks 2 and 4 after surgery was calculated by setting the preoperative VO2max/m2 at 100. Patients were then assigned to a good recovery group (increase of VO2max/m2 ≥85%) or poor recovery group (increase of VO2max/m2 ≤;85%) according to the recovery of VO2max/m2 at 2 weeks after surgery. The preoperative cardiopulmonary function, and various preoperative and intra-operative factors, were compared between the two groups.
RESULTS: Two weeks after surgery, mean VO2max/m2 was 80.9 % compared with before surgery and it was 87.6% at 4 weeks. Univariate analysis showed a significant difference between the two groups in the age, preoperative % forced expiratory volume in 1.0 sec (EEV 1.0%), and thoracotomy method. Multivariate analysis showed that the age and thoracotomy method has a significant influence on recovery of postoperative VO2max/m2.
CONCLUSION: Early return to work after lung resection was possible for young patients with a small thoracotomy wound and good preoperative EEV 1.0%.
CLINICAL IMPLICATIONS: Patients can be selected for early return to work after lung resection according to pre- and intra-operative factors.
DISCLOSURE: Yoshinori Nagamatsu, No Financial Disclosure Information; No Product/Research Disclosure Information