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Indian Journal of Surgery

, Volume 79, Issue 6, pp 504–509 | Cite as

Pulmonary Function After Lobectomy: Video-Assisted Thoracoscopic Surgery Versus Muscle-Sparing Mini-thoracotomy

  • Katsuo Usuda
  • Sumiko Maeda
  • Nozomu Motomo
  • Makoto Tanaka
  • Masakatsu Ueno
  • Yuichiro Machida
  • Motoyasu Sagawa
  • Hidetaka Uramoto
Original Article

Abstract

Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3–4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7–12-cm skin incision spread by rib retractors made of metal and one or two trocars. Pulmonary function tests were performed a week before surgery and 3 months after surgery. There were 14 males and 11 females in VATS lobectomy and 32 males and 30 females in mini-thoracotomy lobectomy. For lobe location (right upper/right lower/left upper/left lower), there were 12/1/8/4 in VATS lobectomy and 16/19/13/14 in mini-thoracotomy lobectomy, respectively. The percent predicted postoperative forced vital capacity (FVC) (postoperative FVC/predicted postoperative FVC × 100) (110 ± 15 %) of VATS lobectomy was significantly higher than that (101 ± 16 %) of mini-thoracotomy lobectomy (P = 0.0124). The percent predicted postoperative forced expiratory volume in 1 s (FEV1) (postoperative FEV1/predicted postoperative FEV1 × 100) (110 ± 15 %) of VATS lobectomy was not significantly higher than that (104 ± 15 %) of mini-thoracotomy lobectomy (P = 0.091). Multiple regression analysis revealed that operative procedure (VATS lobectomy or mini-thoracotomy lobectomy) was the only significant variable contributing to percent predicted postoperative FVC (P = 0.0073) and percent predicted postoperative FEV1 (P = 0.0180). Postoperative FVC after VATS lobectomy is better than after mini-thoracotomy lobectomy.

Keywords

Lung cancer Lobectomy Pulmonary function Video-assisted thoracoscopic surgery (VATS) Mini-thoracotomy 

Abbreviations

VATS

Video-assisted thoracoscopic surgery

NSCLC

Non-small cell lung cancer

Pre FVC

Preoperative forced vital capacity

Pre FEV1

Preoperative forced expiratory volume in 1 s

Post FVC

Postoperative FVC 3 months after surgery

Post FEV1

Postoperative FEV1 3 months after surgery

Predicted post FVC

Predicted postoperative FVC

Predicted post FEV1

Predicted postoperative FEV1

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Association of Surgeons of India 2016

Authors and Affiliations

  • Katsuo Usuda
    • 1
  • Sumiko Maeda
    • 1
  • Nozomu Motomo
    • 1
  • Makoto Tanaka
    • 1
  • Masakatsu Ueno
    • 1
  • Yuichiro Machida
    • 1
  • Motoyasu Sagawa
    • 1
  • Hidetaka Uramoto
    • 1
  1. 1.Department of Thoracic SurgeryKanazawa Medical UniversityIshikawaJapan

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