scholarly journals Changes in Forced Expiratory Volume in 1 Second after Anatomical Lung Resection according to the Number of Segments

2021 ◽  
Vol 54 (6) ◽  
pp. 480-486
Author(s):  
Sun-Geun Lee ◽  
Seung Hyong Lee ◽  
Sang-Ho Cho ◽  
Jae Won Song ◽  
Chang-Mo Oh ◽  
...  
Keyword(s):  
Lung Resection ◽  
Forced Expiratory Volume ◽  
Number Of Segments

scholarly journals Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Benoît Bédat ◽  
Etienne Abdelnour-Berchtold ◽  
Thomas Perneger ◽  
Marc-Joseph Licker ◽  
Alexandra Stefani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Benign Lesion ◽  
Lung Resection ◽  
Primary Lung Cancer ◽  
Forced Expiratory Volume ◽  
University Hospitals ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Abstract Background Compared to lobectomy by video-assisted thoracic surgery (VATS), segmentectomy by VATS has a potential higher risk of postoperative atelectasis and air leakage. We compared postoperative complications between these two procedures, and analyzed their risk factors. Methods We reviewed the records of all patients who underwent anatomical pulmonary resections by VATS from January 2014 to March 2018 in two Swiss university hospitals. All complications were reported. A logistic regression model was used to compare the risks of complications for the two interventions. Adjustment for patient characteristics was performed using a propensity score, and by including risk factors separately. Results Among 690 patients reviewed, the major indication for lung resection was primary lung cancer (86.4%) followed by metastasis resection (5.8%), benign lesion (3.9%), infection (3.2%) and emphysema (0.7%). Postoperatively, there were 80 instances (33.3%) of complications in 240 segmentectomies, and 171 instances (38.0%) of complications in 450 lobectomies (P = 0.73). After adjustment for the patient’s propensity to be treated by segmentectomy rather than lobectomy, the risks of a complication remained comparable for the two techniques (odds ratio for segmentectomy 0.91 (0.61–1.30), p = 0.59). Length of hospital stay and drainage duration were shorter after segmentectomy. On multivariate analysis, an American Society of Anesthesiologists score above 2 and a forced expiratory volume in one second below 80% of predicted value were significantly associated with the occurrence of complications. Conclusions The rate of complications and their grade were similar between segmentectomy and lobectomy by VATS.

Pulmonary function after whole lung radiation in pediatric patients with malignant solid tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10025-10025
Author(s):  
H. Inaba ◽  
L. Zhu ◽  
K. Srivastava ◽  
M. M. Hudson ◽  
M. S. Motosue ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Solid Tumors ◽  
Wilms Tumor ◽  
Pulmonary Function Tests ◽  
Lung Resection ◽  
Childhood Cancer Survivors ◽  
Forced Expiratory Volume ◽  
Boost Irradiation ◽  
Lung Irradiation ◽  
Over Time

10025 Background: Pediatric malignant solid tumors are increasingly curable; whole lung irradiation (WLI) may be used to treat pulmonary tumor involvement. Few studies have addressed long-term pulmonary function after WLI during childhood. Methods: We conducted a retrospective review of pulmonary function tests (PFTs) in 1 year survivors of pediatric malignant solid tumors treated with WLI. We assessed PFT changes over time and the relationship of abnormal values to clinical parameters (diagnosis, radiation dose, and presence or absence of boost lung irradiation or surgical resection). Results: We evaluated 164 PFTs performed on 49 patients with the diagnoses of Wilms tumor (38), rhabdomyosarcoma (5), Ewing sarcoma (3), synovial sarcoma (2), and thymoma (1). Median age at radiation was 6.3 years (range, 0.5–20.2 years); median WLI dose was 12 Gy (range, 10.5–18 Gy). Seventeen (34.7%) had focal pulmonary boost irradiation and 21 (42.9%) had partial lung resection. Across the entire population, forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) declined after irradiation with a median follow-up of 9.3 years. The odds of having a normal FEV1 and FVC decreased by a factor of 0.90 (p = 0.0387) and 0.91 (p = 0.0445), respectively, every year, indicating that the proportion of patients with normal values of FEV1 and FVC decreases over time. FEV1/FVC ratio and forced expiratory flow (FEF25%-75%) remained stable. Abnormal FEV1/FVC and FEF25%-75% were more likely in patients who received boost irradiation than in patients who did not (p = 0.0034 and 0.0233, respectively). Conclusions: Pulmonary function worsened over time in this cohort of childhood cancer survivors treated with WLI. Boost irradiation further impaired pulmonary function. Further studies are planned to assess the clinical consequences of these progressive PFT abnormalities and to identify risk factors associated with clinically significant pulmonary dysfunction after WLI. No significant financial relationships to disclose.

scholarly journals Decrease in pulmonary function and oxygenation after lung resection

2018 ◽  
Vol 4 (1) ◽  
pp. 00055-2017 ◽  
Author(s):  
Barbara Cristina Brocki ◽  
Elisabeth Westerdahl ◽  
Daniel Langer ◽  
Domingos S.R. Souza ◽  
Jan Jesper Andreasen
Keyword(s):  
Muscle Strength ◽  
Pulmonary Function ◽  
Respiratory Muscle ◽  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Lung Cancer Surgery ◽  
Forced Expiratory Volume ◽  
Future Research ◽  
Respiratory Muscle Strength ◽  
Curative Intent

Respiratory deficits are common following curative intent lung cancer surgery and may reduce the patient's ability to be physically active. We evaluated the influence of surgery on pulmonary function, respiratory muscle strength and physical performance after lung resection.Pulmonary function, respiratory muscle strength (maximal inspiratory/expiratory pressure) and 6-min walk test (6MWT) were assessed pre-operatively, 2 weeks post-operatively and 6 months post-operatively in 80 patients (age 68±9 years).Video-assisted thoracoscopic surgery was performed in 58% of cases. Two weeks post-operatively, we found a significant decline in pulmonary function (forced vital capacity −0.6±0.6 L and forced expiratory volume in 1 s −0.43±0.4 L; both p<0.0001), 6MWT (−37.6±74.8 m; p<0.0001) and oxygenation (−2.9±4.7 units; p<0.001), while maximal inspiratory and maximal expiratory pressure were unaffected. At 6 months post-operatively, pulmonary function and oxygenation remained significantly decreased (p<0.001), whereas 6MWT was recovered.We conclude that lung resection has a significant short- and long-term impact on pulmonary function and oxygenation, but not on respiratory muscle strength. Future research should focus on mechanisms negatively influencing post-operative pulmonary function other than impaired respiratory muscle strength.

scholarly journals Comparison between actual and predicted postoperative stair-climbing test, walk test and spirometric values in patients undergoing lung resection

2010 ◽  
Vol 25 (6) ◽  
pp. 535-540 ◽  
Author(s):  
Marcos Vinícius Cataneo Pancieri ◽  
Daniele Cristina Cataneo ◽  
Jair Cortez Montovani ◽  
Antonio José Maria Cataneo
Keyword(s):  
Pulmonary Resection ◽  
Lung Resection ◽  
Forced Expiratory Volume ◽  
Stair Climbing ◽  
Repeated Measure ◽  
Walk Test ◽  
Significance Level ◽  
Measure Anova ◽  
6 Minute Walk Test ◽  
Minute Walk

PURPOSE: To assess whether the tests - Forced Expiratory Volume at one second (FEV1), 6-minute walk test (6MWT) and stair-climbing test (SCT) showed proportional changes after the resection of functioning lung. METHODS: Candidates for pulmonary resection were included. Spirometry, 6MWT and SCT were performed preoperatively (pre) and at least 3 months after surgery (pos). SCT was performed on a staircase with a total ascent height of 12.16m. The time taken to climb the total height the fastest possible was defined as stair-climbing time (SCt). Number of functioning segments lost, was used to calculated predicted postoperative (ppo) tests values. Pre, ppo and pos values for each test were compared. Data were analyzed by repeated-measure ANOVA with significance level set at 5%. RESULTS: A total of 40 patients were enrolled. Pulmonary resection results ranged from gain of 2 functioning segments to loss of 9. Pre, ppo and pos values were the following: preFEV1 = 2.6±0.8L, ppo FEV1 =2.3±0.8L, and pos FEV1=2.3±0.8L, (pre FEV1 > ppo FEV1 = pos FEV1); pre6MWT = 604±63m, ppo6MWT= 529±103m, pos6MWT= 599±74m (pre6MWT = pos6MWT > ppo6MWT); preSCt = 32.9±7.6s, ppoSCt = 37.8±12.1s, posSCt = 33.7±8.5s (preSCt = posSCt < ppoSCt). CONCLUSION: In our group of patients, pulmonary resection led to loss of lung function measured by spirometry, but not to exercise capacity measured by stair-climbing and walk tests.

scholarly journals Physiological and clinical relevance of exercise ventilatory efficiency in COPD

2017 ◽  
Vol 49 (3) ◽  
pp. 1602036 ◽  
Author(s):  
J. Alberto Neder ◽  
Danilo C. Berton ◽  
Flavio F. Arbex ◽  
Maria Clara Alencar ◽  
Alcides Rocha ◽  
...  
Keyword(s):  
Lung Resection ◽  
Forced Expiratory Volume ◽  
Added Value ◽  
Exercise Intolerance ◽  
Chronic Obstructive ◽  
Exercise Tests ◽  
Ventilatory Efficiency ◽  
Respiratory Mortality ◽  
Clinical Scenarios ◽  
Objective Evidence

Exercise ventilation (V′E) relative to carbon dioxide output (V′CO2) is particularly relevant to patients limited by the respiratory system, e.g. those with chronic obstructive pulmonary disease (COPD). High V′E−V′CO2 (poor ventilatory efficiency) has been found to be a key physiological abnormality in symptomatic patients with largely preserved forced expiratory volume in 1 s (FEV1). Establishing an association between high V′E−V′CO2 and exertional dyspnoea in mild COPD provides evidence that exercise intolerance is not a mere consequence of detraining. As the disease evolves, poor ventilatory efficiency might help explaining “out-of-proportion” breathlessness (to FEV1 impairment). Regardless, disease severity, cardiocirculatory co-morbidities such as heart failure and pulmonary hypertension have been found to increase V′E−V′CO2. In fact, a high V′E−V′CO2 has been found to be a powerful predictor of poor outcome in lung resection surgery. Moreover, a high V′E−V′CO2 has added value to resting lung hyperinflation in predicting all-cause and respiratory mortality across the spectrum of COPD severity. Documenting improved ventilatory efficiency after lung transplantation and lung volume reduction surgery provides objective evidence of treatment efficacy. Considering the usefulness of exercise ventilatory efficiency in different clinical scenarios, the V′E−V′CO2 relationship should be valued in the interpretation of cardiopulmonary exercise tests in patients with mild-to-end-stage COPD.

Handheld Office-Based Spirometry versus Laboratory Spirometry in Low-Risk Patients Undergoing Lung Resection

2011 ◽  
Vol 6 (4) ◽  
pp. 257-261 ◽  
Author(s):  
Varun Puri ◽  
Jennifer B. Zoole ◽  
Joanne Musick ◽  
Alexander S. Krupnick ◽  
Daniel Kreisel ◽  
...  
Keyword(s):  
High Risk ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Lung Resection ◽  
Office Visit ◽  
Forced Expiratory Volume ◽  
Low Risk ◽  
Respiratory Morbidity ◽  
Risk Patients ◽  
The Mean

Objective To compare handheld office spirometry with laboratory spirometry in evaluation of low-risk patients undergoing pulmonary resection. Methods Low-risk patients evaluated for lung resection were enrolled in a prospective study and underwent office and laboratory spirometry. Standard laboratory spirometry values were considered the gold standard. Values of forced expiratory volume in 1 second (FEV1) <1.5 L or FEV1% <60% were determined in advance to signal high risk. Results Thirty patients with mean age 64 ± 12 years and median Karnofsky performance status 100 (80–100) were evaluated. The mean FEV1-office spirometry and mean FEV1-laboratory spirometry were comparable (2.14 L vs 2.36 L) as were the mean FEV1%-office spirometry and FEV1%-laboratory spirometry (78% vs 85%). The differences were within limits established a priori. Laboratory spirometry identified 3 of 30 (10%) patients as high risk and office spirometry identified 5 of 30 (16%) patients as high risk, including the 3 patients identified by laboratory spirometry. The sensitivity of office spirometry for detecting high risk was 100% (3/3) and specificity was 93% (25/27). The negative predictive value of office spirometry was 100% (25/25). Office spirometry added a median of 1 minute to the office visit, whereas laboratory spirometry added 42 minutes. Eventually, 25 of 30 (83%) patients underwent lung resection. There were 12 lobar and 13 sublobar resections. One patient developed postoperative respiratory morbidity. This patient was high risk by office spirometry but not by laboratory spirometry. This patient was discharged on home oxygen. Conclusions Office spirometry FEV1 and FEV1% are clinically comparable to formal laboratory spirometry values. Office Spirometry saves time and possibly expense in the preoperative workup of patients evaluated for lung resection.

scholarly journals Risk factors for prolonged air leak and need for intervention following lung resection

2021 ◽  
Author(s):  
Aaron R Dezube ◽  
Daniel P Dolan ◽  
Emanuele Mazzola ◽  
Suden Kucukak ◽  
Luis E De Leon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carbon Monoxide ◽  
Length Of Stay ◽  
Wedge Resection ◽  
Lung Resection ◽  
Forced Expiratory Volume ◽  
Air Leak ◽  
Steroid Use ◽  
Diffusion Capacity ◽  
Prolonged Air Leak

Abstract OBJECTIVES Prolonged air leak (PAL; &gt;5 days) following lung resection is associated with postoperative morbidity. We investigated factors associated with PAL and PAL requiring intervention. METHODS Retrospective review of all patients undergoing lobectomy, segmentectomy or wedge resection from 2016 to 2019 at our institution. Bronchoplastic reconstructions and lung-volume reduction surgeries were excluded. Incidence and risk factors for PAL and PAL requiring intervention were evaluated. RESULTS In total, 2384 patients were included. PAL incidence was 5.4% (129/2384); 22.5% (29/129) required intervention. PAL patients were more commonly male (56.6% vs 39.7%), older (mean age 69 vs 65 years) and underwent lobectomy or thoracotomy (all P &lt; 0.001). Patients with PAL had longer length of stay (9 vs 3 days), more discharge needs and increased odds of complication (all P &lt; 0.050). Twenty-nine patients required intervention (9 chest tubes; 4 percutaneous drains; 16 operations). In 50% of operative interventions, an air leak source was identified; however, the median time from intervention to resolution was 13 days. Patients requiring intervention had increased steroid use, lower diffusion capacity for carbon monoxide and twice the length of stay versus PAL patients (all P &lt; 0.050). On univariable analysis, forced expiratory volume in 1 s (FEV1) &lt;40%, diffusion capacity for carbon monoxide &lt;50%, steroid use and albumin &lt;3 had increased odds of intervention (P &lt; 0.050). CONCLUSIONS Age, gender and operative technique were related to PAL development. Patients with worse forced expiratory volume in 1 s or diffusion capacity for carbon monoxide, steroid use or poor nutrition were less likely to heal on their own, indicating a population that could benefit from earlier intervention.

Preoperative evaluation for lung resection in patients with bronchiectasis: should we rely on standard lung function evaluation?

2021 ◽  
Author(s):  
Alessandro Wasum Mariani ◽  
Camilla Carlini Vallilo ◽  
André Luís Pereira de Albuquerque ◽  
João Marcos Salge ◽  
Marcia Cristina Augusto ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Carbon Monoxide ◽  
Oxygen Consumption ◽  
Postoperative Complications ◽  
Lung Function ◽  
Pulmonary Resection ◽  
Lung Resection ◽  
Forced Expiratory Volume ◽  
Peak Oxygen Consumption ◽  
Surgical Data

Abstract OBJECTIVES The scant data about non-cystic fibrosis bronchiectasis, including tuberculosis sequelae and impairment of lung function, can bias the preoperative physiological assessment. Our goal was to evaluate the changes in lung function and exercise capacity following pulmonary resection in these patients; we also looked for outcome predictors. METHODS We performed a non-randomized prospective study evaluating lung function changes in patients with non-cystic fibrosis bronchiectasis treated with pulmonary resection. Patients performed lung function tests and cardiopulmonary exercise tests preoperatively and 3 and 9 months after the operation. Demographic data, comorbidities, surgical data and complications were collected. RESULTS Forty-four patients were evaluated for lung function. After resection, the patients had slightly lower values for spirometry: forced expiratory volume in 1 s preoperatively: 2.21 l ± 0.8; at 3 months: 1.9 l ± 0.8 and at 9 months: 2.0 l ± 0.8, but the relationship between the forced expiratory volume in 1 s and the forced vital capacity remained. The gas diffusion measured by diffusing capacity for carbon monoxide did not change: preoperative value: 23.2 ml/min/mmHg ± 7.4; at 3 months: 21.5 ml/min/mmHg ± 5.6; and at 9 months: 21.7 ml/min/mmHg ± 8.2. The performance of general exercise did not change; peak oxygen consumption preoperatively was 20.9 ml/kg/min ± 7.4; at 3 months: 19.3 ml/kg/min ± 6.4; and at 9 months: 20.2 ml/kg/min ± 8.0. Forty-six patients were included for analysis of complications. We had 13 complications with 2 deaths. To test the capacity of the predicted postoperative (PPO) values to forecast complications, we performed several multivariate and univariate analyses; none of them was a significant predictor of complications. When we analysed other variables, only bronchoalveolar lavage with positive culture was significant for postoperative complications (P = 0.0023). Patients who had a pneumonectomy had a longer stay in the intensive care unit (P = 0.0348). CONCLUSIONS The calculated PPO forced expiratory volume in 1 s had an excellent correlation with the measurements at 3 and 9 months; but the calculated PPO capacity for carbon monoxide and the PPO peak oxygen consumption slightly underestimated the 3- and 9-month values. However, none of them was a predictor for complications. Better tools to predict postoperative complications for patients with bronchiectasis who are candidates for lung resection are needed. Clinical trial registration number Clinicaltrials.gov: NCT01268475

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