Surgery Today

, Volume 24, Issue 2, pp 103–105 | Cite as

The superiority of exercise testing over spirometry in the evaluation of postoperative lung function for patients with pulmonary disease

  • Noriaki Tsubota
  • Masahiro Yanagawa
  • Masahiro Yoshimura
  • Akehiro Murotani
  • Takeshi Hatta
Original Articles


Thoracic surgeons have often been embarrassed by the discrepancy between an improvement in symptoms and the unchanged or even worse results of spirometry in postoperative patients with either bullae or inflammatory lung disease. Forty-four patients with lung diseases, who underwent a total of 47 operations, were categorized as follows: 12 cases of empyema, 16 cases of giant bulla (undergoing surgery a total of 19 times), 4 cases of bronchiectasis, and 12 cases of other miscellaneous diseases. All patients were tested preoperatively and again 4–6 months after surgery on both the spirometer and treadmill exercise tests. The forced vital capacity (FVC) and forced expiratory volume (FEV1.0) results were as follows: the empyema group 1.82±0.52 liters preoperatively to 1.93±0.69 liters postoperatively and 1.47±0.44 liters to 1.56±0.53 liters, respectively; and the giant bulla group, 3.49±0.96 liters to 3.35±0.77 liters and 2.35±0.96 liters to 2.48±0.69 liters, respectively. However, the exercise time was prolonged in the empyema group from 6.00±3.77 min to 8.33±3.80 min (P<0.01) and in the giant bulla group from 11.83±3.71 min to 12.92±2.84 min (P<0.05). It was thus concluded that exercise testing should be chosen for the postoperative evaluation of patients with inflammatory pulmonary disease and giant bullae, especially if any discrepancies are seen between spirometry and performance status, because on the basis of our results, it appears that the benefits obtained by surgery are best measured by the dynamic values of exercise testing and not by the static values of spirometry at rest.

Key Words

exercise test oxygen consumption postoperative lung function 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Elliott SE, Segger FG, Osborn JJ (1966) A modified oxygen gauge for the rapid measurement of PO2 in respiratory gases. J Appl Physiol 21:1672–1674PubMedGoogle Scholar
  2. 2.
    Sheffield LT, Roitman D (1976) Stress testing methodology. Prog Cardiovasc Dis 19:33–49PubMedCrossRefGoogle Scholar
  3. 3.
    Olsen GN, Weiman DS, Bolton JWR, Gass GD, McLain WC, Schoonover GA, Hormung CA (1989) Submaximal invasive exercise testing and quantitive lung scanning in the evaluation for tolerance of lung resection. Chest 95:267–273PubMedGoogle Scholar
  4. 4.
    Bechard D, Wetstein L (1987) Assessment of exercise oxygen consumption as preoperative criterion for lung resection. Ann Thorc Surg 44:344–349CrossRefGoogle Scholar
  5. 5.
    Mieghem WV, Demedts M (1989) Cardiopulmonary function after lobectomy or pneumonectomy for pulmonary neoplasm. Respir Med 83:199–206PubMedGoogle Scholar
  6. 6.
    Lima O, Ramos L, DiBiasi P, Judice L, Cooper JD (1981) Median sternotomy for bilateral resection of emphysematous bullae. J Thorac Cardiovasc Surg 82:892–897PubMedGoogle Scholar
  7. 7.
    Blanche C, Krellenstein D (1991) Giant emphysematous bullae; Surgical treatment using the median sternotomy approach. Int Surg 76:168–171PubMedGoogle Scholar
  8. 8.
    Ries AL, Farrow JT, Clausen JL (1988) Pulmonary function tests cannot predict exercise-induced hypoxemia in chronic obstructive pulmonary disease. Chest 93:454–459PubMedGoogle Scholar
  9. 9.
    Dantzker DR, D'Alonzo GE (1986) The effect of exercise on pulmonary gas exchange in patients with severe chronic obstructive pulmonary disease. Am Rev Respir Dis 134:1135–1139PubMedGoogle Scholar
  10. 10.
    Wagner PD, Dantzker RD, Dueck R, Clausen JL, West JB (1977) Ventilation-perfusion inequality in chronic obstructive pulmonary disease. J Clin Invest 59:203–216PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • Noriaki Tsubota
    • 1
  • Masahiro Yanagawa
    • 1
  • Masahiro Yoshimura
    • 1
  • Akehiro Murotani
    • 1
  • Takeshi Hatta
    • 2
  1. 1.General Thoracic SurgeryHyogo Medical CenterAkashi, HyogoJapan
  2. 2.Kenritsu Awaji HospitalSumoto, HyogoJapan

Personalised recommendations