Skip to main content
Log in

Physical assessment immediately after lobectomy via miniposterolateral thoracotomy assisted by videothoracoscopy for non-small cell lung cancer

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

We evaluated the invasiveness of videothoracoscopy-assisted mini-posterolateral thoracotomy (VAmPLT) for non-small cell lung cancer (NSCLC).

Methods

This study prospectively analyzed 50 NSCLC patients who underwent VAmPLT lobectomy. We measured maximal negative inspiratory pressure (PImax), maximal positive expiratory pressure (PEmax), quadriceps strength (QS), 6-min walk test (6mWT), and postoperative pain during the perioperative period. We then compared the results of the 6mWT and the postoperative pain of the VAmPLT lobectomy patients with those of a control group of 50 NSCLC patients who underwent standard posterolateral thoracotomy (PLT) techniques just prior to implementation of the VAmPLT lobectomy.

Results

The PImax and PEmax at the baseline, then on postoperative days (PODs) 1, 7, and 14 were 125% ± 5% and 120% ± 4%, 69% ± 4% and 62% ± 4%, 115% ± 5% and 100% ± 4%, and 123% ± 4%, and 110% ± 4%, respectively. The QS at the baseline, then on PODs 7 and 14 was 138% ± 5%, 129% ± 6%, and 133% ± 5%, respectively. Improvement from the baseline was seen in PImax by POD 7, and in PEmax and QS by POD 14. The 6mWT results and the level of postoperative pain after VAmPLT lobectomy were superior to those after PLT.

Conclusions

The advantages of VAmPLT lobectomy over PLT include less postoperative pain and earlier recovery of physical function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ito Y, Oda M, Tsunezuka Y, Matsumoto I, Ishikawa N, Kawakami K, et al. Reduced perioperative immune response in video-assisted versus open surgery in a rat model. Surg Today 2009;39:682–688.

    Article  PubMed  Google Scholar 

  2. Swallow EB, Reyes D, Hopkinson NS, Man WDC, Porcher R, Cetti EJ, et al. Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease. Thorax 2007;62:115–120.

    Article  PubMed  Google Scholar 

  3. Wilcock A, Maddocks M, Lewis M, Howard P, Frisby J, Bell S, et al. Use of a Cybex NORM dynamometer to assess muscle function in patients with thoracic cancer. BMC Palliative Care 2008;7:3.

    Article  PubMed  Google Scholar 

  4. Deloach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intra-subject variability and correlation with a numeric scale. Anesth Analg 1998;86:102–106.

    PubMed  CAS  Google Scholar 

  5. Yoshino I, Ushijima C, Tomiyasu M, Suemitsu R, Ichinose Y, Sugimachi K. Unique minithoracotomy assisted by videothoracoscopy facilitates a maximal view even with a minimal wound for resection of primary lung cancer. Surg Endosc 2002;16:148–150.

    Article  PubMed  CAS  Google Scholar 

  6. Rosner B. Fundamentals of biostatistics. 4th ed. Belmont: Duxbury Press; 1995.

    Google Scholar 

  7. Scheffe H. A method for judging all contrasts in the analysis of variance. Biometrika 1969;56:229.

    Google Scholar 

  8. Nakata M, Saeki H, Yokoyama N, Kurita A, Takiyama W, Takashima S. Pulmonary function after lobectomy: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg 2000;70:938–941.

    Article  PubMed  CAS  Google Scholar 

  9. Nomori H, Horio H, Naruke T, Suemasu K. What is the advantage of a thoracoscopic lobectomy over a limited thoracotomy procedure for lung cancer surgery? Ann Thorac Surg 2001;72:879–884.

    Article  PubMed  CAS  Google Scholar 

  10. Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure. Ann Thorac Surg 2001;72:362–365.

    Article  PubMed  CAS  Google Scholar 

  11. Petersen RP, Pham D, Burfeind WR, Hanish SI, Toloza EM, Harpole DH Jr, et al. Thoracoscopic lobectomy facilitates the delivery of chemotherapy after resection for lung cancer. Ann Thorac Surg 2007;83:1245–1249.

    Article  PubMed  Google Scholar 

  12. Nicastri DG, Wisnivesky JP, Litle VR, Yun J, Chin C, Dembitzer FR, et al. Thoracoscopic lobectomy: report on safety, discharge independence, pain, and chemotherapy tolerance. J Thorac Cardiovasc Surg 2008;135:642–647.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maruyama, R., Tanaka, J., Kitagawa, D. et al. Physical assessment immediately after lobectomy via miniposterolateral thoracotomy assisted by videothoracoscopy for non-small cell lung cancer. Surg Today 41, 908–913 (2011). https://doi.org/10.1007/s00595-010-4372-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-010-4372-3

Key words

Navigation