scholarly journals Thoracoscopic left S1 + 2 segmentectomy as a good resolution for preserving pulmonary function

2020 ◽  
Vol 31 (3) ◽  
pp. 331-338
Author(s):  
Shinya Tane ◽  
Wataru Nishio ◽  
Yusuke Fujibayashi ◽  
Megumi Nishikubo ◽  
Yuki Nishioka ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Good Alternative ◽  
Forced Expiratory Volume ◽  
Good Resolution ◽  
Postoperative Function ◽  
3 Dimensional ◽  
Postoperative Pulmonary Function ◽  
Left Upper Lobectomy ◽  
Preservation Rate

Abstract OBJECTIVES Segmentectomies such as S1 + 2, S1 + 2+3 and S4 + 5 segmentectomy are used to treat patients with non-small-cell lung cancer (NSCLC) in the left upper lobe. However, the preservable lung volume and changes after such segmentectomies remain unknown. We compared the residual pulmonary function after thoracoscopic segmentectomy or lobectomy in the left upper lobe and examined the efficacy of S1 + 2 segmentectomy regarding postoperative pulmonary function. METHODS Patients with left upper lobe NSCLC who underwent thoracoscopic segmentectomy or lobectomy were included. Spirometry and computed tomography were performed before and 6 months after resection, and the ipsilateral preserved lobe volume was calculated using 3-dimensional computer tomography. The percentage of postoperative/preoperative forced expiratory volume in 1 s and actual/predicted regional forced expiratory volume in 1 s (preservation rate) in the residual lobe were compared. RESULTS Eighty-eight patients underwent lobectomy and 70 patients underwent segmentectomy (23 S1 + 2, 35 S1 + 2+3 and 12 S4 + 5 segmentectomies). The percentage of postoperative/preoperative forced expiratory volume in 1 s was 97 in S1 + 2, 82 in S1 + 2+3, 86 in S4 + 5 segmentectomy and 73 in left upper lobectomy, indicating that segmentectomy could be a meaningful approach to preserve pulmonary function. The preservation rate was 83% in S1 + 2 and 62% in S1 + 2+3 segmentectomy and was significantly higher in S1 + 2 than in S1 + 2+3 segmentectomy (P < 0.001). CONCLUSIONS Postoperative pulmonary function and the preservable lung volume of the residual lobe after thoracoscopic S1 + 2 segmentectomy were well-preserved among other segmentectomies and lobectomy. Thoracoscopic S1 + 2 segmentectomy is a good alternative for preserving postoperative function.

scholarly journals Airway to Lung Volume Ratio on CT is Associated with Pulmonary Function Transition from Obstructive to Restrictive Pattern in Obesity

2022 ◽  
Author(s):  
Xin Yu ◽  
Ming-Hui Zhang ◽  
Yan-Hao Huang ◽  
Yu Deng ◽  
You-Zhen Feng ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Volume Ratio ◽  
Lung Ventilation ◽  
Forced Expiratory Volume ◽  
Obese Adults ◽  
Obese Adolescents ◽  
Wall Area ◽  
Adolescents And Adults ◽  
Airway Tree

Abstract Background: Obesity is associated with excessive airway collapse and reduced lung volume; it is unknown whether it affects airway-lung interactions. We sought to compare the airway tree to lung volume ratio, assessed by CT, in obese individuals with and without ventilation disorders.Methods: Participants underwent inspiratory chest CT and pulmonary function. The percentage ratio of the whole airway tree to lung volume, automatically segmented via deep learning, was defined as CT airway volume percent (AWV%). Total airway count (TAC), airway wall area percent (WA%), and other CT indexes were also measured. Results: We evaluated 88 participants including adolescents(age: 14-18, n= 12) and adults (age: 19-25, n= 17; age: 26-35, n= 39; age> 35, n= 20). Obese adolescents had higher forced vital capacity (FVC) (P = 0.001) and lower AWV% (P = 0.008) than obese adults (age >35). Among obese adults, participants with restrictive disorders had larger AWV% (P < 0.001) and those with obstructive disorders showed smaller AWV% (P < 0.001) compared to participants with normal ventilation. AWV% was positively correlated with age and forced expiratory volume in 1 second (FEV1)/FVC and adversely related to FVC (P< 0.05 for all), and in multivariate models, AWV% independently predicted FEV1/FVC (R2 = 0.49, P < 0.001) and FVC (R2 = 0.60, P < 0.001).Conclusion: Transitions in lung function patterns between obese adolescents and adults are associated with airway to lung ratios. The obesity-induced disproportion between the airway tree and lung volume may adversely affect and complicate lung ventilation.

scholarly journals Pulmonary Emphysema Regional Distribution and Extent Assessed by Chest Computed Tomography Is Associated With Pulmonary Function Impairment in Patients With COPD

2021 ◽  
Vol 8 ◽  
Author(s):  
Plácido Gomes ◽  
Hélder Novais e Bastos ◽  
André Carvalho ◽  
André Lobo ◽  
Alan Guimarães ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Pulmonary Emphysema ◽  
Regional Distribution ◽  
Airway Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Total Lung Volume ◽  
Emphysema Severity ◽  
Function Impairment

Objective: This study aimed to evaluate how emphysema extent and its regional distribution quantified by chest CT are associated with clinical and functional severity in patients with chronic obstructive pulmonary disease (COPD).Methods/Design: Patients with a post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) &lt; 0.70, without any other obstructive airway disease, who presented radiological evidence of emphysema on visual CT inspection were retrospectively enrolled. A Quantitative Lung Imaging (QUALI) system automatically quantified the volume of pulmonary emphysema and adjusted this volume to the measured (EmphCTLV) or predicted total lung volume (TLV) (EmphPLV) and assessed its regional distribution based on an artificial neural network (ANN) trained for this purpose. Additionally, the percentage of lung volume occupied by low-attenuation areas (LAA) was computed by dividing the total volume of regions with attenuation lower or equal to −950 Hounsfield units (HU) by the predicted [LAA (%PLV)] or measured CT lung volume [LAA (%CTLV)]. The LAA was then compared with the QUALI emphysema estimations. The association between emphysema extension and its regional distribution with pulmonary function impairment was then assessed.Results: In this study, 86 patients fulfilled the inclusion criteria. Both EmphCTLV and EmphPLV were significantly lower than the LAA indices independently of emphysema severity. CT-derived TLV significantly increased with emphysema severity (from 6,143 ± 1,295 up to 7,659 ± 1,264 ml from mild to very severe emphysema, p &lt; 0.005) and thus, both EmphCTLV and LAA significantly underestimated emphysema extent when compared with those values adjusted to the predicted lung volume. All CT-derived emphysema indices presented moderate to strong correlations with residual volume (RV) (with correlations ranging from 0.61 to 0.66), total lung capacity (TLC) (from 0.51 to 0.59), and FEV1 (~0.6) and diffusing capacity for carbon monoxide DLCO (~0.6). The values of FEV1 and DLCO were significantly lower, and RV (p &lt; 0.001) and TLC (p &lt; 0.001) were significantly higher with the increasing emphysema extent and when emphysematous areas homogeneously affected the lungs.Conclusions: Emphysema volume must be referred to the predicted and not to the measured lung volume when assessing the CT-derived emphysema extension. Pulmonary function impairment was greater in patients with higher emphysema volumes and with a more homogeneous emphysema distribution. Further studies are still necessary to assess the significance of CTpLV in the clinical and research fields.

Distinctive patterns of pulmonary function change according to baseline lung volume and diffusing capacity

2020 ◽  
Vol 24 (6) ◽  
pp. 597-605
Author(s):  
J. Kang ◽  
Y-M. Oh ◽  
J-H. Lee ◽  
E. K. Kim ◽  
S. Y. Lim ◽  
...  
Keyword(s):  
South Korea ◽  
Pulmonary Function ◽  
Lung Volume ◽  
Forced Expiratory Volume ◽  
Random Coefficients ◽  
Chronic Obstructive ◽  
Diffusing Capacity ◽  
Obstructive Pulmonary Disease ◽  
Function Change ◽  
Physiological Markers

SETTING: Multicentre retrospective study in South Korea.OBJECTIVE: To longitudinally evaluate changes in lung volume and diffusing capacity for carbon monoxide (DLCO) with forced expiratory volume in 1 sec (FEV1).DESIGN: A total of 155 patients with chronic obstructive pulmonary disease (COPD), whose pulmonary function parameters were measured annually for 5 years, were selected from a prospective cohort in South Korea. A random coefficients model was used to estimate mean annual FEV1, lung volume parameter and DLCO change rates.RESULTS: Patients were classified into four groups based on baseline DLCO and residual volume/total lung capacity (RV/TLC) measurements. The annual FEV1 decline rate was greater in patients with low DLCO than in those with normal DLCO, with the greatest decline occurring in patients with low DLCO and normal RV/TLC. RV and RV/TLC declined in patients with high RV/TLC, whereas these increased in patients with normal RV/TLC. DLCO decreased longitudinally in all four groups, with the greatest decline occurring in patients with normal DLCO and normal RV/TLC.CONCLUSIONS: Different subgroups of patients with COPD exhibited distinctive pulmonary function change patterns. Baseline DLCO and RV/TLC may be used as physiological markers to predict long-term changes in pulmonary function.

Nursing care of the thoracoscopic lung volume reduction patient

1996 ◽  
Vol 5 (6) ◽  
pp. 412-419
Author(s):  
KJ Vaca ◽  
JF Osterloh ◽  
CJ Daake ◽  
NR Noedel
Keyword(s):  
Quality Of Life ◽  
Pulmonary Function ◽  
Nursing Care ◽  
Lung Volume ◽  
Forced Expiratory Volume ◽  
Minute Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction ◽  
Prolonged Air Leak

BACKGROUND: Several methods to surgically enhance pulmonary function and improve the quality of life in patients with bullous emphysema are currently being evaluated. One of these methods, lung volume reduction, is performed in patients with bullous emphysema that can no longer be well managed with medical therapy. OBJECTIVES: The focus of this article is to review bullectomy via unilateral thoracoscopy with an endoscopic stapler in the management of end-stage pulmonary emphysema, and to discuss nursing care of these patients. METHODS: An experimental study was used, including review of the literature and analysis of clinical experience using chi-square and t test analyses of pre- and postoperative variables. RESULTS: At 3-month follow-up there were significant improvements in forced expiratory volume in 1 second, forced vital capacity, minute volume ventilation, partial pressure of oxygen, residual volume, and 6-minute walk when pre- and postoperative parameters were compared. Operative mortality was 4%, with the most common complication being prolonged air leak, occurring in 30% of patients studied. CONCLUSIONS: There is now consistent preliminary information to support the concept that lung volume reduction improves pulmonary function and quality of life in a significant percentage of patients.

The effect of thoracic surgery on pulmonary function

1995 ◽  
Vol 4 (5) ◽  
pp. 352-354 ◽  
Author(s):  
KK Hallfeldt ◽  
M Siebeck ◽  
O Thetter ◽  
L Schweiberer
Keyword(s):  
Retrospective Study ◽  
Thoracic Surgery ◽  
Pulmonary Function ◽  
Postoperative Morbidity ◽  
Pulmonary Resection ◽  
Forced Expiratory Volume ◽  
Surgical Trauma ◽  
Operative Trauma ◽  
Postoperative Pulmonary Function ◽  
Main Factor

BACKGROUND: Pulmonary function is a main factor influencing postoperative morbidity and mortality in thoracic surgery. OBJECTIVE: To determine the significance of surgical trauma on postoperative pulmonary function by comparing the preoperative forced expiratory volume in 1 second with that obtained 14 days after surgery. METHODS: A retrospective study was conducted on 385 consecutive patients undergoing elective thoracic surgery over 3 years. RESULTS: Operative trauma alone effected a reduction of approximately 0.6 L per second in the value of forced expiratory volume in 1 second irrespective of the extent of pulmonary resection. Significant differences in the overall reduction among enucleation, segmental resection, lobectomy, and pneumonectomy were not observed. CONCLUSIONS: The data indicated that the remaining lung tissue was severely compromised throughout the postoperative period and that surgical trauma was the main factor influencing postoperative pulmonary function for at least 2 weeks.

scholarly journals Comparison of Pulmonary Function After Selective Anterior Versus Posterior Fusion for the Correction of Thoracolumbar and Lumbar Adolescent Idiopathic Scoliosis

2019 ◽  
Vol 10 (4) ◽  
pp. 433-437
Author(s):  
Satoru Demura ◽  
Kota Watanabe ◽  
Teppei Suzuki ◽  
Toshiki Saito ◽  
Takuya Yamamoto ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pulmonary Function ◽  
Spinal Fusion ◽  
Anterior Approach ◽  
Forced Expiratory Volume ◽  
Postoperative Pulmonary Function ◽  
Radiographic Measurements ◽  
Significant Difference

Study Design: Retrospective multicenter study. Objectives: To compare the selective anterior spinal fusion (ASF) versus posterior spinal fusion (PSF) on postoperative pulmonary function testing (PFT) whether thoracotomy with separation of the diaphragm by anterior approach influences the PFT in thoracolumbar and lumbar adolescent idiopathic scoliosis (AIS). Methods: A multicenter series of AIS patients who underwent selective spinal fusion were retrospectively reviewed. Seventy-nine female patients were included (mean 15.8 years). There were 35 patients in the ASF group and 44 patients in the PSF group. Patient demographics, radiographic measurements, and PFT data from preoperative to 2-year follow-up were analyzed. Results: Preoperatively, there were no significant differences in PFTs between the groups. The ASF group patients were more likely to undergo shorter fusions (4.5 instrumented vertebral levels) than those in the PSF group (5.2 levels). At 2-year follow-up, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in ASF group were statistically lower than those in PSF group. When comparing preoperative and 2-year changes on each procedure, only %FVC showed significant difference in ASF while FVC, FEV1, and %FEV1 did not. Meanwhile, the ASF group showed a significant decrease in FVC at 6 and 12 months compared to preoperative values. In PSF group, there was a decrease at 6 months, returned to preoperative value at 1-year follow-up. Conclusions: Pulmonary function after ASF and PSF was similar at 2 years; however, anterior group did not return to the baseline at 6 months and 1 year suggesting anterior approach may affect early postoperative pulmonary function.

Assessment of factors affecting short-term pulmonary functions following cardiac surgery: A prospective observational study

2021 ◽  
pp. 021849232110100
Author(s):  
Neetika Katiyar ◽  
Sandeep Negi ◽  
Sunder Lal Negi ◽  
Goverdhan Dutt Puri ◽  
Shyam Kumar Singh Thingnam
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Operative Morbidity ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Significant Impairment

Background Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV1) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery. Methods This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained. Results The FEV1 and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV1 was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV1 and forced vital capacity. Discussion This study observed a significant impairment in FEV1 and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV1 and forced vital capacity were pre-operative FEV1, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.

scholarly journals Association of Olfactory and Pulmonary Function in Middle-Aged and Older Adults: The Korea National Health and Nutrition Examination Survey

2021 ◽  
Vol 10 (7) ◽  
pp. 1535
Author(s):  
Ji-Sun Kim ◽  
Jun-Ook Park ◽  
Dong-Hyun Lee ◽  
Ki-Hong Chang ◽  
Byung Guk Kim
Keyword(s):  
Older Adults ◽  
Pulmonary Function ◽  
National Health ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Olfactory Dysfunction ◽  
Nutrition Examination Survey ◽  
Middle Aged ◽  
Health And Nutrition ◽  
Olfactory Testing

Objectives: To identify the relationship between pulmonary function and subjective olfactory dysfunction in middle-aged and older adults. Materials and Methods: We used Korea National Health and Nutrition Examination Survey data from 2010 to 2012 to analyze 6191 participants in their 50s or older. Results: The frequency of olfactory dysfunction was 6.8% among the subjects with normal pulmonary function tests, but was significantly more frequent in those diagnosed with restrictive (9.6%) or obstructive (10.1%) pulmonary function. Forced volume vital capacity, forced expiratory volume (FEV)1, FEV6, and peak expiratory flow were significantly lower in the olfactory dysfunction group. The risk of olfactory dysfunction was significantly associated with obstructive pulmonary function (odds ratio (OR) [95% confidence interval (CI)]: 1.449 [1.010–2.081]) after adjusting for confounders (sex, rhinitis, chronic rhinosinusitis, hypertension, dyslipidemia, education level, stress, depressed mood, and suicidal ideation). Conclusion: Middle-aged and older adults with obstructive pulmonary function had a higher incidence of subjective olfactory dysfunction than the normal pulmonary function group. Early olfactory testing may improve the quality of life of patients with obstructive pulmonary function.

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