HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Takashi Tojo Shigeki Taniguchi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kushibe, K. Articles by Taniguchi, S. Search for Related Content PubMed PubMed Citation Articles by Kushibe, K. Articles by Taniguchi, S. Related Collections Lung - other

Eur J Cardiothorac Surg 2006;29:886-890
© 2006 Elsevier Science NL

Assessment of pulmonary function after lobectomy for lung cancer — upper lobectomy might have the same effect as lung volume reduction surgery

Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Nara 634-8522, Japan

Received 28 December 2005; received in revised form 20 February 2006; accepted 27 February 2006.

^_* Corresponding author. Tel.: +81 744 22 3051; fax: +81 744 24 8040. (Email: mdkeiji{at}m3.kcn.ne.jp).

Objective: Lung volume reduction surgery (LVRS) in well-selected patients with severe emphysema results in postoperative improvement in symptoms and pulmonary function. Experience with LVRS suggests that predicted postoperative FEV_1.0 may be underestimated after lobectomy in patients with lung cancer and emphysema. As most of the patients with lung cancer have more or less emphysematous changes in the lungs, we assumed that lobectomy would achieve the same effect as LVRS even in patients without chronic obstructive pulmonary disease on the pulmonary function test. We assessed changes in pulmonary function in terms of ‘volume reduction effect’ after lobectomy for lung cancer. Methods: Forty-three patients underwent right upper lobectomy (RUL), 38 patients left upper lobectomy (LUL), 39 patients right lower lobectomy (RLL), and 38 patients left lower lobectomy (LLL). Pulmonary function tests were performed preoperatively and 6 months to 1 year after surgery. Results: Percent change in FEV_1.0 after lobectomy was –6.9 ± 16.1% in RUL group, –11.2 ± 16.9% in LUL group, –14.7 ± 9.8% in RLL group, and –12.8 ± 9.5% in LLL group. We evaluated the correlation between a preoperative FEV_1.0% of predicted and percentage change in FEV_1.0 after lobectomy. There were no significant relationships between these variables in RLL or LLL group. In contrast, there were significant negative relationships between these variables in RUL and LUL groups. Correlation coefficients were r = –0.667, p < 0.0001 for RUL and r = –0.712, p < 0.0001 for LUL. In RUL and LUL groups, patients with a higher preoperative FEV_1.0% of predicted had a more adverse percentage change in FEV_1.0 after surgery. In addition, all 13 patients with a preoperative FEV_1.0% of predicted <60% in RUL and LUL groups had an increase in FEV_1.0 postoperatively. Patients with a lower preoperative FEV_1.0% of predicted had a greater ‘volume reduction effect’ with an increase in FEV_1.0 after upper lobectomy. Conclusion: Upper lobectomy might have a volume reduction effect.

Key Words: Lung cancer • Upper lobectomy • Pulmonary emphysema • Lung volume reduction surgery • Lobar volume reduction effect

This article has been cited by other articles:

				A. Brunelli, A. Charloux, C. T. Bolliger, G. Rocco, J-P. Sculier, G. Varela, M. Licker, M. K. Ferguson, C. Faivre-Finn, R. M. Huber, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy) Eur. Respir. J., July 1, 2009; 34(1): 17 - 41. [Abstract] [Full Text] [PDF]

				L. Luzzi, S. Tenconi, L. Voltolini, P. Paladini, C. Ghiribelli, M. Di Bisceglie, and G. Gotti Long-term respiratory functional results after pneumonectomy. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 164 - 168. [Abstract] [Full Text] [PDF]

				K. Kushibe, T. Kawaguchi, M. Kimura, M. Takahama, T. Tojo, and S. Taniguchi Exercise capacity after lobectomy in patients with chronic obstructive pulmonary disease Interactive CardioVascular and Thoracic Surgery, June 1, 2008; 7(3): 398 - 401. [Abstract] [Full Text] [PDF]

				G. Varela, A. Brunelli, G. Rocco, M. F. Jimenez, M. Salati, and T. Gatani Evidence of Lower Alteration of Expiratory Volume in Patients With Airflow Limitation in the Immediate Period After Lobectomy Ann. Thorac. Surg., August 1, 2007; 84(2): 417 - 422. [Abstract] [Full Text] [PDF]

				A. Brunelli, F. Xiume, M. Refai, M. Salati, R. Marasco, V. Sciarra, and A. Sabbatini Evaluation of Expiratory Volume, Diffusion Capacity, and Exercise Tolerance Following Major Lung Resection: A Prospective Follow-up Analysis Chest, January 1, 2007; 131(1): 141 - 147. [Abstract] [Full Text] [PDF]