A survey of pulmonary function abnormalities following thoracotomy

Exploring pulmonary function and physical function in childhood cancer: A systematic review

BACKGROUND

Children with cancer experience pulmonary and physical function side effects from the cancer itself and the medical interventions. This systematic review examines the known relationship between pulmonary function and physical function in childhood cancer and identifies gaps in the literature.

METHODS

A search of Ovid Medline, CINAHL (EbscoHost) and Embase to identify literature from 2009 to March 2020.

RESULTS

Fifty-seven studies met inclusion criteria. Thirty-seven studies reported impaired pulmonary function. Incidence of pulmonary dysfunction ranged from 45.5 % to 84.1 %. Eighteen studies reported impaired physical function. Three studies investigated the relationship between pulmonary function and physical function. No studies explored inspiratory muscle strength.

CONCLUSION

Pulmonary function and physical function are related and frequently impaired in children during and after cancer treatment. A literature gap was found in diaphragm function and its relationship with physical function. Future studies should focus on interventions that target the pulmonary mechanisms impacting physical function.

Long-term pulmonary function after lobectomy for congenital pulmonary airway malformation: is thoracoscopic approach really better than open?

INTRODUCTION

Congenital pulmonary airway malformation (CPAM) is the most common lung pathology diagnosed antenatally. Thoracoscopic lobectomy has shown increasing popularity, but the long-term result is still lacking. In this study we compared long -term pulmonary function after thoracoscopic and open lobectomy.

METHODS

All CPAM patients with lobectomy between 2000 and 2008 were recruited into the study. Pulmonary function test (PFT) was performed at least 7 years after operation. Demographic data and PFT results were analyzed. Comparison was made between the thoracoscopic and open group.

RESULTS

Twelve patients were included in each group. PFT was performed at a mean age of 9.8 (thoracoscopic) and 12.2 years (open), respectively (p = 0.17). The thoracoscopic group showed better performance in forced vital capacity (FVC) (98.9 vs 84.3% predicted, p = 0.03), forced expiratory volume in 1 s (FEV1) (88.5 vs 76.1% predicted, p = 0.04), and alveolar volume adjusted diffusion capacity of carbon monoxide (106.4 vs 91.4% predicted, p = 0.03). FEV1 to FVC ratio, total lung capacity, and residual volume showed no statistical difference.

CONCLUSION

The long term PFT result following thoracoscopic lobectomy is better than open lobectomy. This may be due to impaired respiratory musculature after thoracotomy. Further study with larger sample size is necessary to determine this hypothesis.

LEVEL-OF-EVIDENCE

III.

Medium Term Pulmonary Function Test After Thoracoscopic Lobectomy for Congenital Pulmonary Airway Malformation: A Comparative Study with Normal Control

INTRODUCTION

Congenital pulmonary airway malformation (CPAM) is a major indication of lobectomy in children. Early lobectomy had been proposed for the advantage of compensatory lung growth. Despite the increasing use of thoracoscopic lobectomy its effect on postoperative lung function was still not well established in the literature. This study was therefore performed to study the result of postoperative pulmonary function test (PFT) on a medium term basis.

MATERIALS AND METHODS

All patients who underwent thoracoscopic lobectomy for CPAM between 2006 and 2010 were recruited into the study. PFT was performed 5 years after the operation. Age-matched healthy individuals with similar body size were recruited for PFT as the control group. Demographic data and PFT results were extracted for statistical analysis. Test result less than 80% of predicted value was considered abnormal.

RESULTS

Fifteen consecutive patients were identified in the study period, 8 boys and 7 girls. The PFT was performed at a mean age of 9 years. None of the patients had respiratory symptoms. The forced vital capacity (FVC) (99.6% versus 97.0% predicted, P = .56), forced expiratory volume in 1 second (FEV1) (86.0% versus 89.1% predicted, P = .52), FEV1 to FVC ratio (96.6% versus 98.7% predicted, P = .60), total lung capacity (92.5% versus 94.5% predicted, P = .68), and alveolar volume adjusted diffusion capacity of carbon monoxide (106.4% versus 100.4% predicted, P = .35) showed no statistical difference from the control group.

CONCLUSION

Patients who underwent thoracoscopic lobectomy have normal lung function 5 years after the operation. Further study is necessary to confirm the long-term result.