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Lung volume reduction surgery and nutritional status in patients with severe emphysema

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Abstract

Objective: We studied the short-term effect of lung volume reduction surgery on nutritional status including body composition and the relationship between preoperative nutritional status and postoperative morbidity.Methods: Subjects were 28 patients with emphysema who underwent bilateal thoracoscopic lung volume reduction surgery (23 simultaneously, 5 staged). Functional tests, body weight, and body composition were measured before and 6 months after surgery. Fat-free mass and fat mass were assessed by bioelectrical impedance analysis.Results: FEV10 improved 35.2% following surgery and maximal oxygen uptake 23.8%. Body weight and fat-free mass increased significantly after surgery, while fat mass was unchanged. Of the 23 undergoing simultaneous bilateral lung volume reduction surgery, 8 had major complications-3 required additional surgery to close air leaks, 3 required mechanical ventilation (>72 hrs), and 2 developed postoperative infection. The preoperative percentage of ideal body weight and fat-free mass was significantly higher among patients without major complications.Conclusions: Bilateral lung volume reduction surgery increases fat-free mass and provides functional improvement for underweight patients with severe emphysema. We found fat-free mass and body weight to be good predictors of unacceptable postoperative complications following bilateral lung volume reduction surgery.

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References

  1. Donahoe M, Rogers RM, Cottrell JJ. Is loss of body weight in chronic obstructive pulmonary disease patients with emphysema secondary to low tissue oxygenation? Respiration 1992; 24 (Suppl. 2): 33–39.

    Article  Google Scholar 

  2. Openbrier DR, Irwin MM, Rogers RM, Gottlieb GP, Dauber JH, Van Thiel DH, et al., Nutritional status and lung function in patients with emphysema and chronic bronchitis. Chest 1983; 83: 17–22.

    Article  CAS  PubMed  Google Scholar 

  3. Arora NS, Rochester DF. Respiratory muscle strength and maximal voluntar ventilation in undernourished patients. Am Rev Respir Dis 1982; 126: 5–8.

    PubMed  CAS  Google Scholar 

  4. Russell DMcR, Predergast PJ, Darby PL. A comparison between muscle function and body composition in anorexia nervosa: the effects of refeeding. Am J Clin Nutr 1983; 38: 229–37.

    Article  CAS  PubMed  Google Scholar 

  5. Wilson DO, Rogers RM, Wright EC, Anthonisen NR. Body weight in chronic obstructive pulmonary disease: the National Institutes of Health intermittent positive-pressure breathing trial. Am Rev Respir Dis 1989; 139: 1435–8.

    Article  CAS  PubMed  Google Scholar 

  6. Cooper JD, Trulock EP, Triantafillou AN, Patterson GA, Pohl MS, Deloney PA, et al., Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease. J. Thorac Cardiovasc Surg 1995; 109: 107–19.

    Article  Google Scholar 

  7. Cooper JD, Patterson GA, Sundaresan RS, Trulock EP, Yusen RD, Pohl MS, et al., Results of 150 consecutive bilateral lung volume reduction procedures in patients with severe emphysema. J Thorac Cardiovasc Surg 1996; 112: 1319–29.

    Article  CAS  PubMed  Google Scholar 

  8. Keenan RJ, Landreneau RJ, Sciurba FC, Ferson PF, Holbert JM, Brown ML, et al., Unilateral surgical approach for diffuse emphysema. J Thorac Cardiovasc Surg 1996; 111: 308–16.

    Article  CAS  PubMed  Google Scholar 

  9. McKenna RJ, Brenner M, Gelb AF, Mullin M, Singh N, Peters H, et al., A randomized prospective trial of stapled lung reduction versus laser bullectomy for diffuse emphysema. J Thorac Cardiovasc Surg 1996; 111: 317–22.

    Article  PubMed  Google Scholar 

  10. Christensen PJ, Paine III R, Curtis JL, Kazerooni EA, Iannettoni MD, Martinez FJ, Weight gain after lung volume reduction surgery is not correlated with improvement in pulmonary mechanics. Chest 1999; 116: 1601–7.

    Article  CAS  PubMed  Google Scholar 

  11. Japanese Ministry of Welfare and Health, Health Service Bureau, Health Promotion and Nutritional Division. Recommended dietary allowances for the Japanese, 4th revision. Tokyo: Daiichi Shuppan, 1990; 124.

    Google Scholar 

  12. Shols AMWJ, Wouters EFM, Soeters PB, Westerterp KR. Body composition by bioelectrical impedance analysis compared to deuterium and skinfold anthropometry in patients with chronic obstructive pulmonary disease. Am J Clin Nutr 1991; 53: 421–4.

    Article  Google Scholar 

  13. Baarends EM, Schols AMWJ, Mostert R, Wouters EFM. Peak exercise response in relation to tissue depletion in patients with chronic obstructive pulmonary disease. Eur Respir J 1997; 10: 2807–13.

    Article  CAS  PubMed  Google Scholar 

  14. Roberts JR, Bavaria JE, Wahl P, Wurster A, Friedberg JS, Kaiser LR. Comparison of open and thoracoscopic bilateral volume reduction surgery: comparison analysis. Ann Thorac Surg 1998; 66: 1759–65.

    Article  CAS  PubMed  Google Scholar 

  15. Miller JI, Lee RB, Mansour KA. Lung volume reduction surgery: lessons learned. Ann Thorac Surg 1996; 61: 1464–9.

    Article  PubMed  Google Scholar 

  16. Nezu K, Yoshikawa M, Yoneda T, Kushibe K, Kawaguchi T, Yasukawa M, et al., The change in body composition after bilateral lung volume reduction surgery for underweight patients with severe emphysema. Lung 2000; 178: 381–9.

    Article  CAS  PubMed  Google Scholar 

  17. Pichard C, Kyle UG, Janssens JP, Burdet L, Rochat T, Slosman O, et al., Body composition by X-ray absorptiometry and bioelectrical impedance in chronic Respiratory insufficiency patients. Nutrition 1997; 13: 952–8.

    Article  CAS  PubMed  Google Scholar 

  18. Nishimura Y, Tsutsumi M, Nakata H, Tsunenari T, Maeda H, Yokoyama M. Relationship between respiratory muscle strength and lean body mass in men with COPD. Chest 1995; 107: 1232–6.

    Article  CAS  PubMed  Google Scholar 

  19. Kobayashi A, Yoneda T, Yoshikawa M, Nezu K, Ikuno M, Takenaka H, et al., The relation of fat-free mass to maximum exercise performance in patients with chronic obstructive pulmonary disease. Lung 2000; 178: 119–27.

    Article  CAS  PubMed  Google Scholar 

  20. Yoshikawa M, Yoneda T, Kobayashi A, Fu A, Takenaka H, Nezu K, et al., Body composition analysis by dual energy X-ray absorptiometry and exercise performance in underweight patients with COPD. Chest 1999; 115: 371–5.

    Article  CAS  PubMed  Google Scholar 

  21. Schols AMWJ, Soeters PB, Mostert R, Pluymers RJ, Wouters EFM. Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 152: 1268–74.

    Article  CAS  PubMed  Google Scholar 

  22. Wilson DO, Rogers RM, Wright EC, Anthonisen NR, Body weight in chronic obstructive pulmonary disease: the National Institutes of Health intermittent positive-pressure breathing trial. Am Rev Respir Dis 1986; 139: 1435–8.

    Article  Google Scholar 

  23. Schols AMWJ, Mostert R, Soeters PB, Wouters EFM. Body composition and exercise performance in patients with chronic obstructive pulmonary disease. Thorax 1991; 46: 695–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Szekely LS, Oelberg DA, Wright C, Johnson DC, Wain J, Trotman-Dickenson B, et al., Preoperative predictors of operative morbidity and mortality in COPD patients undergoing bilateral lung volume reduction surgery. Chest 1997; 111: 550–8.

    Article  CAS  PubMed  Google Scholar 

  25. Mazolewski P, Turner JF, Baker M, Kurtz T, Little AG, The impact of nutritional status on the outcome of lung volume reduction surgery. A prospective study. Chest 1999; 116: 693–6.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery III, Nara Medical University, 840 Shijo-cho, 634-8522, Kashihara, Nara, Japan

    Kunimoto Nezu, Takeshi Kawaguchi, Michitaka Kimura, Motoaki Yasukawa, Keiji Kushibe & Shigeki Taniguchi

  2. Department of Internal Medicine, Nara Medical University, Nara, Japan

    Masahiro Yoshikawa

Authors
  1. Kunimoto Nezu
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  2. Takeshi Kawaguchi
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  3. Michitaka Kimura
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  4. Motoaki Yasukawa
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  5. Keiji Kushibe
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  6. Shigeki Taniguchi
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  7. Masahiro Yoshikawa
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Additional information

Read at the Fifty-Annual Meeting of the Japanese Association for Thoracic Surgery, Panel discussion, Oita, October 25–27, 2000.

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Nezu, K., Kawaguchi, T., Kimura, M. et al. Lung volume reduction surgery and nutritional status in patients with severe emphysema. Jpn J Thorac Cardiovasc Surg 49, 552–556 (2001). https://doi.org/10.1007/BF02913531

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  • DOI: https://doi.org/10.1007/BF02913531

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