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Kwon OB, Lee HU, Park HE, Choi JY, Kim JW, Lee SH, Yeo CD. Predicting Postoperative Lung Function in Patients with Lung Cancer Using Imaging Biomarkers. Diseases 2024; 12:65. [PMID: 38667523 PMCID: PMC11049658 DOI: 10.3390/diseases12040065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
There have been previous studies conducted to predict postoperative lung function with pulmonary function tests (PFTs). Computing tomography (CT) can quantitatively measure small airway walls' thickness, lung volume, pulmonary vessel volume, and emphysema area, which reflect the severity of respiratory diseases. These measurements are considered imaging biomarkers. This study aimed to predict postoperative lung function with imaging biomarkers. A retrospective analysis of 79 patients with lung cancer who had undergone lung surgery was completed. Postoperative lung function measured by forced expiratory volume in one second (FEV1) was defined as an outcome. Preoperative clinico-pathological parameters and imaging biomarkers representing airway walls' thickness, severity of emphysema, total lung volume, and pulmonary vessel volume were measured quantitatively in chest CT by an automated segmentation software, AVIEW COPD. Pi1 was defined as the first percentile along the histogram of lung attenuation that represents the degree of emphysema. Wafw was defined as the airway thickness, which was calculated by the full-width at half-maximum method. Logistic and linear regressions were used to assess these variables. If the actual postoperative FEV1 was higher than the postoperative FEV1 projected by a formula, the group was considered to be preserved. Among the 79 patients, 16 of the patients were grouped as a non-preserved group, and 63 of them were grouped as a preserved group. The patients in the preserved FEV1 group had a higher vessel volume than the non-preserved group. Pi1 and Wafw were independent predictors of postoperative lung function. Imaging biomarkers can be considered significant variables in predicting postoperative lung function in patients with lung cancer.
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Affiliation(s)
- Oh-Beom Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (O.-B.K.); (J.-Y.C.); (J.-W.K.); (S.-H.L.)
- Department of Internal Medicine, Kangwon National University Hospital, Chuncheon 24289, Republic of Korea
| | - Hae-Ung Lee
- Coreline Soft Co., Ltd., Seoul 03991, Republic of Korea; (H.-U.L.); (H.-E.P.)
| | - Ha-Eun Park
- Coreline Soft Co., Ltd., Seoul 03991, Republic of Korea; (H.-U.L.); (H.-E.P.)
| | - Joon-Young Choi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (O.-B.K.); (J.-Y.C.); (J.-W.K.); (S.-H.L.)
| | - Jin-Woo Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (O.-B.K.); (J.-Y.C.); (J.-W.K.); (S.-H.L.)
| | - Sang-Haak Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (O.-B.K.); (J.-Y.C.); (J.-W.K.); (S.-H.L.)
| | - Chang-Dong Yeo
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (O.-B.K.); (J.-Y.C.); (J.-W.K.); (S.-H.L.)
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Smoking Habit and Respiratory Function Predict Patients' Outcome after Surgery for Lung Cancer, Irrespective of Histotype and Disease Stage. J Clin Med 2023; 12:jcm12041561. [PMID: 36836096 PMCID: PMC9967492 DOI: 10.3390/jcm12041561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/05/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Growing evidence suggests that sublobar resections offer more favorable outcomes than lobectomy in early-stage lung cancer surgery. However, a percentage of cases that cannot be ignored develops disease recurrence irrespective of the surgery performed with curative intent. The goal of this work is thus to compare different surgical approaches, namely, lobectomy and segmentectomy (typical and atypical) to derive prognostic and predictive markers. PATIENTS AND METHODS Here we analyzed a cohort of 153 NSCLC patients in clinical stage TNM I who underwent pulmonary resection surgery with a mediastinal hilar lymphadenectomy from January 2017 to December 2021, with an average follow-up of 25.5 months. Partition analysis was also applied to the dataset to detect outcome predictors. RESULTS The results of this work showed similar OS between lobectomy and typical and atypical segmentectomy for patients with stage I NSCLC. In contrast, lobectomy was associated with a significant improvement in DFS compared with typical segmentectomy in stage IA, while in stage IB and overall, the two treatments were similar. Atypical segmentectomy showed the worst performance, especially in 3-year DFS. Quite unexpectedly, outcome predictor ranking analysis suggests a prominent role of smoking habits and respiratory function, irrespective of the tumor histotype and the patient's gender. CONCLUSIONS Although the limited follow-up interval cannot allow conclusive remarks about prognosis, the results of this study suggest that both lung volumes and the degree of emphysema-related parenchymal damage are the strongest predictors of poor survival in lung cancer patients. Overall, these data point out that greater attention should be addressed to the therapeutic intervention for co-existing respiratory diseases to obtain optimal control of early lung cancer.
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Yun JK, Jeong JH, Lee GD, Kim HR, Kim YH, Kim DK, Park SI, Choi S. Predicting Postoperative Complications and Long-Term Survival After Lung Cancer Surgery Using Eurolung Risk Score. J Korean Med Sci 2022; 37:e36. [PMID: 35132842 PMCID: PMC8822110 DOI: 10.3346/jkms.2022.37.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study aimed to assess the clinical relevance of the parsimonious Eurolung risk scoring system for predicting postoperative morbidity, mortality, and long-term survival in Korean patients with surgically resected non-small cell lung cancer. METHODS This retrospective analysis used the data of patients who underwent anatomical resection for non-small cell lung cancer between 2004 and 2018 at a single institution. The parsimonious aggregate Eurolung score was calculated for each patient. The Cox regression model was used to determine the ability of the Eurolung scoring system for predicting long-term outcomes. RESULTS Of the 7,278 patients in the study, cardiopulmonary complications and mortality occurred in 687 (9.4%) and 53 (0.7%) patients, respectively. The rate of cardiopulmonary complications and mortality gradually increased with the increase in the Eurolung risk scores (all P < 0.001). When risk scores were grouped into four categories, the Eurolung scoring system showed a stepwise deterioration of overall survival with the increase in risk scores, and this association was statistically significant (P < 0.001). Multivariate Cox analysis showed that the Eurolung scoring system, classified into four categories, was a significant prognostic factor of overall survival even after adjusting for covariates such as tumor histology and pathological stage (P < 0.001). CONCLUSION Stratification based on the parsimonious Eurolung scoring system showed good discriminatory ability for predicting postoperative morbidity, mortality, and long-term survival in South Korean patients with surgically resected non-small cell lung cancer. This might help clinicians to provide a detailed prognosis and decide the appropriate treatment option for high-risk patients with non-small cell lung cancer.
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Affiliation(s)
| | | | - Geun Dong Lee
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Hyeong Ryul Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Yong-Hee Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Dong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Seung-Il Park
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Sehoon Choi
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
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Mohd Razali MS, Ibrahim MA, Mohammad Razi AA, Abdul Rani MF. Endobronchial resection as a bridge to curative resection in patient with poor preoperative lung function secondary to an airway blocking endobronchial carcinoid tumour. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211050708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We present a 70-year-old gentleman with chronic cough with haemoptysis found to have left lower zone collapse on imaging. The bronchoscopy showed an endobronchial mass histologically of a non-secreting atypical carcinoid. Poor baseline lung function excluded surgical resection, and instead, he successfully underwent a bronchoscopic debulking procedure which improved his FEV1 to 84% and DLCO 83% predicted. Unfortunately, the tumour regrew, but the calculated percentage predicted postoperative for FEV1 (64%), and DLCO (65%) enabled definitive surgical resection to take place. Surgical resection remains the definite curative option for localised endobronchial atypical carcinoid tumours. Achieving this in proximal endobronchial carcinoid tumour is a challenge. We described an endoscopic tumour debulking procedure as a bridge for curative surgical resection in a patient with an inoperable proximal atypical carcinoid tumour due to poor predicted postoperative lung function. We highlighted the need to assess predicted postoperative lung function with functional and quantitative perfusion methods to aid surgical planning. Debulking the tumour by endoscopy can be used as a conduit to curative surgical resection in bronchial carcinoid tumour. The choice of calculating the percentage predicted values by either or both methods must be individualised based on tumour location and the probability of converting a lobectomy to a pneumonectomy. This precautionary approach could evaluate the postoperative lung function and morbidity and mortality risk if considering a pneumonectomy. Endoscopic debulking can be a successful bridge to a curative surgical resection aided by comprehensive preoperative lung function tests to predict postoperative lung values
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Affiliation(s)
- Muhammad Syafiek Mohd Razali
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - Muhammad Amin Ibrahim
- Internal Medicine/Respiratory and Sleep Study Department,Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - Adli Azam Mohammad Razi
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
| | - Mohammed Fauzi Abdul Rani
- Internal Medicine/Respiratory and Sleep Study Department,Universiti Teknologi MARA (UiTM), Sungai Buloh, Malaysia
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Lee SG, Lee SH, Cho SH, Song JW, Oh CM, Kim DH. Changes in Forced Expiratory Volume in 1 Second after Anatomical Lung Resection according to the Number of Segments. J Chest Surg 2021; 54:480-486. [PMID: 34857671 PMCID: PMC8646069 DOI: 10.5090/jcs.21.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/05/2021] [Accepted: 09/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background Although various methods are already used to calculate predicted postoperative forced expiratory volume in 1 second (FEV1) based on preoperative FEV1 in lung surgery, the predicted postoperative FEV1 is not always the same as the actual postoperative FEV1. Observed postoperative FEV1 values are usually the same or higher than the predicted postoperative FEV1. To overcome this issue, we investigated the relationship between the number of resected lung segments and the discordance of preoperative and postoperative FEV1 values. Methods From September 2014 to May 2020, the data of all patients who underwent anatomical lung resection by video-assisted thoracoscopic surgery (VATS) were gathered and analyzed retrospectively. We investigated the association between the number of resected segments and the differential FEV1 (a measure of the discrepancy between the predicted and observed postoperative FEV1) using the t-test and linear regression. Results Information on 238 patients who underwent VATS anatomical lung resection at Kyung Hee University Hospital at Gangdong and by DH. Kim for benign and malignant disease was collected. After applying the exclusion criteria, 114 patients were included in the final analysis. In the multiple linear regression model, the number of resected segments showed a positive correlation with the differential FEV1 (Pearson r=0.384, p<0.001). After adjusting for multiple covariates, the differential FEV1 increased by 0.048 (95% confidence interval, 0.023–0.073) with an increasing number of resected lung segments (R2=0.271, p<0.001). Conclusion In this study, after pulmonary resection, the number of resected segments showed a positive correlation with the differential FEV1.
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Affiliation(s)
- Sun-Geun Lee
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Seung Hyong Lee
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sang-Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Won Song
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Chang-Mo Oh
- Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dae Hyun Kim
- Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
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Kwon OB, Yeo CD, Lee HY, Kang HS, Kim SK, Kim JS, Park CK, Lee SH, Kim SJ, Kim JW. The Value of Residual Volume/Total Lung Capacity as an Indicator for Predicting Postoperative Lung Function in Non-Small Lung Cancer. J Clin Med 2021; 10:jcm10184159. [PMID: 34575273 PMCID: PMC8470520 DOI: 10.3390/jcm10184159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/25/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most frequently occurring concomitant diseases in patients with non-small cell lung cancer (NSCLC). It is characterized by small airways and the hyperinflation of the lung. Patients with hyperinflated lung tend to have more reserved lung function than conventionally predicted after lung cancer surgery. The aim of this study was to identify other indicators in predicting postoperative lung function after lung resection for lung cancer. Patients with NSCLC who underwent curative lobectomy with mediastinal lymph node dissection from 2017 to 2019 were included. Predicted postoperative FEV1 (ppoFEV1) was calculated using the formula: preoperative FEV1 × (19 segments-the number of segments to be removed) ÷ 19. The difference between the measured postoperative FEV1 and ppoFEV1 was defined as an outcome. Patients were categorized into two groups: preserved FEV1 if the difference was positive and non-preserved FEV1, if otherwise. In total, 238 patients were included: 74 (31.1%) in the FEV1 non-preserved group and 164 (68.9%) in the FEV1 preserved group. The proportion of preoperative residual volume (RV)/total lung capacity (TLC) ≥ 40% in the FEV1 non-preserved group (21.4%) was lower than in the preserved group (36.1%) (p = 0.03). In logistic regression analysis, preoperative RV/TLC ≥ 40% was related to postoperative FEV1 preservation. (adjusted OR, 2.02, p = 0.041). Linear regression analysis suggested that preoperative RV/TLC was positively correlated with a significant difference. (p = 0.004) Preoperative RV/TLC ≥ 40% was an independent predictor of preserved lung function in patients undergoing curative lobectomy with mediastinal lymph node dissection. Preoperative RV/TLC is positively correlated with postoperative lung function.
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Affiliation(s)
- Oh-Beom Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
| | - Chang-Dong Yeo
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
| | - Hwa-Young Lee
- Division of Allergy, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Hye-Seon Kang
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
| | - Sung-Kyoung Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
| | - Ju-Sang Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
| | - Chan-Kwon Park
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
| | - Sang-Haak Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
- Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Seung-Joon Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
- Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary’s Hospital, Seoul 06591, Korea
- Postech-Catholic Biomedical Engineering Institute, Songeui Multiplex Hall, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jin-Woo Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (O.-B.K.); (C.-D.Y.); (H.-S.K.); (S.-K.K.); (J.-S.K.); (C.-K.P.); (S.-H.L.); (S.-J.K.)
- Correspondence:
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Vagvolgyi A, Rozgonyi Z, Kerti M, Agathou G, Vadasz P, Varga J. Effectiveness of pulmonary rehabilitation and correlations in between functional parameters, extent of thoracic surgery and severity of post-operative complications: randomized clinical trial. J Thorac Dis 2018; 10:3519-3531. [PMID: 30069349 DOI: 10.21037/jtd.2018.05.202] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Pulmonary rehabilitation can be effective in perioperative condition. Our aim was to examine whether the changes of functional markers are significant and search connections between these values and the severity of postoperative complications. Methods A total of 238 chronic obstructive pulmonary disease (COPD) patients underwent perioperative pulmonary rehabilitation with thoracic surgery. Health status and the following parameters were examined: lung function (FEV1, FVC), chest kinematics [chest wall expansion (CWE)], 6-minute walking test (6MWT), breath holding time (BHT), grip strength (GS) and exercise capacity. Patients were separated into three groups: 72 patients had preoperative rehabilitation only (PRE group), 80 had only postoperative rehabilitation (POS group), and 86 patients underwent pre- and postoperative rehabilitation as well (PPO group). Postoperative complications were classed as "severe" and "not severe". We evaluated the changes in functional parameters. Significance was recognized at P<0.05. Connections in between variables and severity of complications were analyzed. Results Pulmonary rehabilitation resulted significant changes of all examined parameters in all three groups. The direction of changes were favourable, so all of the changes can be considered to be improvement [PRE: CWE: 4.2±2.3 vs. 5.8±2.2 cm; FEV1: 63.2±15.6 vs. 70.1±16.6%pred; 6-minute walking distance (6MWD): 392.9±93.5 vs. 443.2±86.6 m; FVC: 83.1±15.9 vs. 90.9±15.6%pred; POS: CWE: 2.9±1.4 vs. 5.0±2.0 cm; FEV1: 56.4±15.6 vs. 64.6±16.0%pred; 6MWD: 354.7±90.7 vs. 437.0±96.0 m; FVC: 66.2±18.7 vs. 76.1±17.7%pred; PPO: preoperatively: CWE: 4.0±2.1 vs. 5.6±2.6 cm; FEV1: 58.2±15.1 vs. 67.0±14.6%pred; 6MWD: 378.3±90.5 vs. 441.3±86.4 m; FVC: 82.4±16.7 vs. 93.3±16.7%pred; postoperatively: CWE: 2.7±1.5 vs. 4.4±2.2 cm; FEV1: 47.4±13.0 vs. 53.4±14.7%pred; 6MWD: 341.4±115.9 vs. 403.3±98.4 m; FVC: 63.6±16.9 vs. 72.6±18.6%pred; P<0.05]. BHT, GS, dyspnoea and health status were also improved significantly. By discriminant analysis 5 of the variables proved to have discriminative value: kilometers travelled via cycle ergometer at the onset of the preoperative rehabilitation, gender, FEV1 after preoperative rehabilitation, extent of the operation and 6MWD before preoperative rehabilitation. These 5 parameters can predict severe complications correctly in 72.5% of all cases. Conclusions Pulmonary rehabilitation can reduce the functional depletion caused by the thoracic surgical operation. Identification of more predictive factors of severe complications can help making preoperative risk stratification more precisely.
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Affiliation(s)
- Attila Vagvolgyi
- Department of Thoracic Surgery, National Koranyi Institute for Pulmonology, Budapest, Hungary
| | - Zsolt Rozgonyi
- Department of Anaesthesiology and Intensive Care, National Koranyi Institute for Pulmonology, Budapest, Hungary
| | - Maria Kerti
- Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary
| | - George Agathou
- Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary
| | - Paul Vadasz
- Department of Thoracic Surgery, National Koranyi Institute for Pulmonology, Budapest, Hungary
| | - Janos Varga
- Department of Pulmonary Rehabilitation, National Koranyi Institute for Pulmonology, Budapest, Hungary
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