Original Article

Surgery Today

, Volume 40, Issue 10, pp 923-930

First online:

Efficacy of perioperative administration of long-acting bronchodilator on postoperative pulmonary function and quality of life in lung cancer patients with chronic obstructive pulmonary disease. Preliminary results of a randomized control study

  • Hidemi SuzukiAffiliated withDepartment of Thoracic Surgery, Chiba UniversityDepartment of Thoracic Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center
  • , Yasuo SekineAffiliated withDepartment of Thoracic Surgery, Chiba UniversityDepartment of Thoracic Surgery, Tokyo Women’s Medical University, Yachiyo Medical Center
  • , Shigetoshi YoshidaAffiliated withDepartment of Thoracic Surgery, Chiba University
  • , Makoto SuzukiAffiliated withDepartment of Thoracic Surgery, Chiba University
  • , Kiyoshi ShibuyaAffiliated withDepartment of Thoracic Surgery, Chiba University
  • , Yuichi TakiguchiAffiliated withDepartment of Respirology, Graduate School of Medicine, Chiba University
  • , Koichiro TatsumiAffiliated withDepartment of Respirology, Graduate School of Medicine, Chiba University
  • , Ichiro YoshinoAffiliated withDepartment of Thoracic Surgery, Chiba University

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Abstract

Purpose

Long-acting bronchodilators are recommended as a first-line treatment for chronic obstructive pulmonary disease (COPD), although their effects for postoperative lung cancer patients with COPD are still not well known. A prospective randomized trial was used to examine the efficacy of bronchodilators on postoperative pulmonary function and quality of life (QOL).

Methods

Twenty lung cancer patients with COPD who had lobectomies were randomized. A control group (n = 10) did not receive bronchodilators. An experimental group (n = 10) received tiotropium and salmeterol. Patients were divided into two COPD grades: stage I COPD and stage II–III COPD. Results for pulmonary function, 6-minute walking test, and the St. George’s Respiratory Questionnaire (SGRQ) were compared. Diaphragmatic motion on dynamic magnetic resonance imaging was also analyzed.

Results

The patient demographics were similar in the two groups. Except for pulmonary function results at 2 weeks, no other parameters were significantly different. However, in stage II–III COPD, forced expiratory volume in 1 second, forced vital capacity, inspiratory capacity, the total score of the SGRQ, and diaphragmatic motion in the experimental group (n = 5) were significantly better than those in the control group (n = 4) at various time points (all P < 0.05).

Conclusion

The daily inhalation of bronchodilators was effective for maintaining the respiratory function and QOL in lung cancer patients with moderate to severe COPD.

Key words

Chronic obstructive pulmonary disease Non-small cell lung cancer Bronchodilator Quality of life