Thorac Cardiovasc Surg 2007; 55(8): 500-504
DOI: 10.1055/s-2007-965630
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Impact on Pulmonary Function after Lobectomy in Patients with Chronic Obstructive Pulmonary Disease

T. Schattenberg1 , T. Muley1 , H. Dienemann1 , J. Pfannschmidt1
  • 1Department of Thoracic Surgery, Thoraxklinik am Universitätsklinikum, Heidelberg, Germany
Further Information

Publication History

received January 30, 2007

Publication Date:
19 November 2007 (online)

Abstract

Objective: The purpose of this study was to evaluate the operative outcome and pulmonary function after lobectomy; this included systematic mediastinal and hilar lymph node dissection for primary non-small cell lung cancer or pulmonary metastases of extrapulmonary origin in patients with chronic obstructive pulmonary disease (COPD) and a preoperative FEV1 of less than 1.5 l (< 80 % of predicted value) and FEV1/FVC < 70 % (COPD II°). Methods: A retrospective analysis was undertaken in 79 patients who had consecutively undergone lobectomy with a preoperative FEV1 < 1.5 l (< 80 %) and FEV1/FVC < 70 % (COPD II°). Inclusion criteria were the ability to complete pulmonary function tests and lobectomy for malignancy. Patients with small cell lung cancer and unable to quit smoking less than 6 months prior to surgery were excluded. In 38 cases, pulmonary function tests were performed at 3 months after surgery, and 16 patients had tests at 3 and 6 months. Results: A total of 79 patients were included in this study, with a median age of 70 years (range: 45 - 85 years). The median preoperative FEV1 was 1.3 l (range: 0.8 - 1.5 l), and patients underwent assisted ventilation for less than 1 hour after surgery (range: 0 - 214 h), and stayed for less than 24 h in the intensive care unit (range: 1 h-56 d). Three patients (3.8 %) died within 30 days after lobectomy. In 14 patients, additional treatment for surgical complications was performed (17.7 %). Follow-up after surgery revealed a significant decrease in FVC and FEV1 (- 17 % and - 8 %, p < 0.005), but function had improved again (+ 10 % and + 11 %, p < 0.05) at 3 months after surgery and remained stable at 6 months after lobectomy. No statistically significant changes were noticed for paO2 and paCO2 values after surgical treatment. Conclusions: It appears that surgical resection of malignant lung tumours by lobectomy can also be performed successfully in selected patients with low FEV1 and COPD II° without significant loss of pulmonary function.

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MD Joachim Pfannschmidt

Department of Thoracic Surgery
Thoraxklinik am Universitätsklinikum

Amalienstraße 5

69126 Heidelberg

Germany

Phone: + 49 6 22 13 96 11 02

Fax: + 49 62 21 39 68 11 01

Email: joachim.pfannschmidt@thoraxklinik-heidelberg.de