Abstract

BackgroundThe pattern and factors influencing the lung function recovery in the first postoperative days are still not fully elucidated, especially in patients at increased risk.MethodsProspective study on 60 patients at increased risk, who underwent a lung resection for primary lung cancer. Inclusion criteria: complete resection and one or more known risk factors in form of COPD, cardiovascular disorders, advanced age or other comorbidities. Previous myocardial infarction, myocardial revascularization or stenting, cardiac rhythm disorders, arterial hypertension and myocardiopathy determined the increased cardiac risk. The severity of COPD was graded according to GOLD criteria. The trend of the postoperative lung function recovery was assessed by performing spirometry with a portable spirometer.ResultsCardiac comorbidity existed in 55%, mild and moderate COPD in 20% and 35% of patients respectively. Measured values of FVC% and FEV1% on postoperative days one, three and seven, showed continuous improvement, with significant difference between the days of measurement, especially between days three and seven. There was no difference in the trend of the lung function recovery between patients with and without postoperative complications. Whilst pO2 was decreasing during the first three days in a roughly parallel fashion in patients with respiratory, surgical complications and in patients without complications, a slight hypercapnia registered on the first postoperative day was gradually abolished in all groups except in patients with cardiac complications.ConclusionExtent of the lung resection and postoperative complications do not significantly influence the trend of the lung function recovery after lung resection for lung cancer.

Highlights

  • The pattern and factors influencing the lung function recovery in the first postoperative days are still not fully elucidated, especially in patients at increased risk

  • The preoperative lung function assessment is focused to the prediction of postoperative ventilatory function and to the estimate of cardiorespiratory reserve

  • Postoperative lung function assessment The trend of the postoperative lung function recovery was assessed by performing spirometry with a portable spirometer “Viasys Spiro Pro”, with a patient in the sitting position in bed, with chest tubes connected and under maximal analgesia (NSAIDS and tramadol-chloride)

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Summary

Introduction

The pattern and factors influencing the lung function recovery in the first postoperative days are still not fully elucidated, especially in patients at increased risk. The preoperative lung function assessment is focused to the prediction of postoperative ventilatory function and to the estimate of cardiorespiratory reserve. Numerous studies evaluated late effects of lung resection (3–6 months after surgery), related to quality of life, length of survival and exercise tolerance That is the reason why the aim of this study was to analyze trends of the lung function changes in patients at risk in the immediate postoperative course, regardless of the presence and type of postoperative complications

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