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Predictive factors inhibiting recovery of the respiratory function after anatomical pulmonary resection

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Abstract

Purpose

Some patients have worse actual observed postoperative (apo) respiratory function values than predicted postoperative (ppo) values. The present study therefore clarified the predictive factors that hinder the recovery of the postoperative respiratory function.

Methods

This study enrolled 255 patients who underwent anatomical pulmonary resection for lung cancer. A pulmonary function test (PFT) was carried out before surgery and at one, three, and six months after surgery. In each surgical procedures, the forced expiratory volume in 1 s (FEV1) ratio was calculated as the apo value divided by the ppo value. In addition, we investigated the predictive factors that inhibited postoperative respiratory function improvement in patients with an FEV1 ratio < 1.0 at 6 months after surgery.

Results

The FEV1 ratio gradually improved over time in all surgical procedures. However, 49 of 196 patients who underwent a PFT at 6 months after surgery had an FEV1 ratio < 1.0. In a multivariate analysis, right side, upper lobe, segmentectomy and pleurodesis for prolonged air leakage were independent significant predictors of a decreased FEV1 ratio (p = 0.003, 0.006, 0.001, and 0.009, respectively).

Conclusion

Pleurodesis was the only controllable factor that might help preserve the postoperative respiratory function. Thus, the intraoperative management of air leakage is important.

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Data availability

The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study.

Abbreviations

PFT:

Pulmonary function test

FEV1:

Forced expiratory volume in 1 s

VC:

Vital capacity

DLCO:

Diffusing capacity of the lung for carbon monoxide

ppo:

Predicted postoperative

apo:

Actual observed postoperative

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Funding

This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour, and Welfare of Japan, and the Smoking Research Foundation.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-Chome, Bunkyo-Ku, Tokyo, 113-8431, Japan

    Hiroyasu Ueno, Kazuya Takamochi, Mariko Fukui, Aritoshi Hattori, Takeshi Matsunaga & Kenji Suzuki

  2. Department of General Thoracic Surgery, Juntendo Nerima Hospital, Tokyo, Japan

    Shunki Hirayama & Takamitsu Banno

Authors
  1. Hiroyasu Ueno
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  2. Kazuya Takamochi
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  3. Shunki Hirayama
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  4. Mariko Fukui
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  5. Aritoshi Hattori
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  6. Takeshi Matsunaga
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  7. Takamitsu Banno
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  8. Kenji Suzuki
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Correspondence to Hiroyasu Ueno.

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Ueno, H., Takamochi, K., Hirayama, S. et al. Predictive factors inhibiting recovery of the respiratory function after anatomical pulmonary resection. Surg Today 53, 1081–1088 (2023). https://doi.org/10.1007/s00595-023-02666-0

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  • DOI: https://doi.org/10.1007/s00595-023-02666-0

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