Role of inhaled tiotropium on the perioperative outcomes of patients with lung cancer and chronic obstructive pulmonary disease.
BACKGROUND
Tiotropium, a long-acting bronchodilator, can be used perioperatively in patients with lung cancer and airway obstruction, although its benefits for the perioperative outcome remain unclear.


METHODS
We prospectively collected the perioperative data of 44 patients with resectable lung cancer and untreated airway obstruction. Tiotropium was not used before September 2007 (control group, n = 24) but was used routinely thereafter (treated group, n = 20). We estimated a propensity score to adjust comparisons between the groups.


RESULTS
Tiotropium improved preoperative global pulmonary function significantly, especially in four patients. Postoperative outcomes in these major responders were significantly better than those in the remaining minor responders. However, postoperative outcomes were not significantly different between the treated group (n = 15) and the control group (n = 15) matched by a propensity score.


CONCLUSIONS
Regardless of its favorable effects on preoperative pulmonary function, we could not establish a significant benefit of tiotropium for postoperative outcomes overall. Nonetheless, our data suggested that tiotropium might have improved the postoperative outcomes of major responders.
Ueda
K
K
Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan. kaueda@c-able.ne.jp
Tanaka
T
T
Hayashi
M
M
Hamano
K
K
D000280:Administration, Inhalation; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D019990:Perioperative Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012129:Respiratory Function Tests; D012602:Scopolamine Derivatives / Q000008:administration & dosage*; D000069447:Tiotropium Bromide; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide