Impact of Lung Resection Surgery in Pulmonary Function

Abstract

PURPOSE: Surgery is the best treatment choice for most of pulmonary lesions. Pulmonary function tests (PFT) play an important role in this process by assessing the risks and the functional effects of the procedure. Our goal was to evaluate the impact of lung resection surgery on pulmonary function. METHODS: Retrospective analysis of all patients submitted to a lung resection surgery, with pre and postoperative PFT performed between 2010 and 2012. RESULTS: We included 26 patients, with an average age of 56 years. PFT were normal in 65% of cases. A wegde resection was performed in 2 patients, a segmentectomy in 6, a lobectomy in 13 and a pneumectomy in 4. A benign lesion was identified in 54% of cases. After surgery, we observed a global reduction of the forced expiratory volume in 1 second (FEV1) (pre mean: 2,62L/99,3%; post; 2,13L/81,5%), and of the forced vital capacity (FVC) (pre mean: 3,14L/ 101%; post: 2,79L/88%), but only in 7 patients for values < 80%. In 2 cases the values of FEV1 and FVC improved after surgery and in 4 there was only an increase in FVC. All of these 6 patients were non smokers and in 50% the preoperative pulmonary function tests were normal; 4 underwent a lobectomy and 2 a segmentectomy; all were submitted to postoperative respiratory rehabilitation. FEV1 worsened in 24 patients, with a mean reduction of 20,3%, and FVC in 20 patients, with a mean reduction of 17,6%. The worsening of FEV1 and FVC was statistically related to the type of surgery, with a greater reduction after lobectomy and pneumectomy. CONCLUSIONS: Our results illustrate a negative, but not highly significant, functional impact of lung ressection surgery. As discussed in literature, the impact is greater after larger surgical resections.