Exercise capacity after lobectomy in patients with chronic obstructive pulmonary disease.
The aim of this study is to clarify whether patients with chronic obstructive pulmonary disease (COPD) lose less exercise capacity after lobectomy than do those without COPD, to the same extent as ventilatory capacity and lobectomy for selected patients with severe emphysema improve exercise capacity like ventilatory capacity. Seventy non-COPD patients (N group), 16 mild COPD patients (M group), and 14 moderate-to-severe COPD patients (S group) participated. Pulmonary function and exercise capacity tests were performed on the same day preoperatively and six months to one year after lobectomy. The S group lost significantly less FEV(1) (forced expiratory volume in 1 s) after lobectomy than did the N or M group (P<0.0001 and P<0.005). However, their loss of exercise capacity was equivalent to that for the N and M groups. For the S group, there was a significant, negative correlation between preoperative FEV(1) % of predicted and percentage change in FEV(1) and maximum oxygen consumption (VO2 max) after lobectomy (r=-0.93, P<0.0001 and r=-0.64, P=0.01). In moderate-to-severe COPD patients, patients with a lower preoperative FEV(1) % of predicted experienced a smaller decrease in FEV(1) and VO2 max after lobectomy.
Kushibe
Keiji
K
Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, 840, Shijo-cho, Kashihara, Nara, 634-8522, Japan. mdkeiji@m3.kcn.ne.jp
Kawaguchi
Takeshi
T
Kimura
Michitaka
M
Takahama
Makoto
M
Tojo
Takashi
T
Taniguchi
Shigeki
S
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011013:Pneumonectomy; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012123:Pulmonary Ventilation; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome