CARDIOPULMONARY FUNCTION AT REST AND DURING EXERCISE AFTER RESECTION FOR BRONCHIAL-CARCINOMA

Background. Measurements of postoperative spirometric values after pne umonectomy and lobectomy vary considerably, and few researchers have s tudied the changes in exercise capacity during maximal work after lung resection. The purpose of this study was to describe the postoperativ e alterations in cardiopulmonary function. Methods. Ninety-seven conse cutive patients with lung malignancy were prospectively examined with maximal exercise test, spirometry, and arterial gas tensions. Fifty-se ven patients were reinvestigated 6 months postoperatively. Results. In patients having lobectomy, forced expiratory volume in 1 second decre ased 8%, and exercise capacity, expressed by maximal oxygen uptake and maximal work rate, significantly decreased 13%. In patients having pn eumonectomy forced expiratory volume in 1 second significantly decreas ed 23%, but the loss in lung volume was partly compensated as measured by exercise capacity, which decreased only 16%. Generally patients wi th the smallest preoperative forced vital capacity had the smallest po stoperative deterioration expressed in percentages. We found a weak co rrelation between alterations in maximal oxygen uptake and lung functi on after resection. Conclusions. Lobectomy is associated with only min or deterioration of lung function and exercise capacity. Pneumonectomy causes a decrease in pulmonary volumes to about 75% of the preoperati ve values, partly compensated in better oxygen uptake, which postopera tively was about 85% of the preoperative values, Alteration in forced expiratory volume in 1 second is a poor predictor of change in exercis e capacity after pulmonary resection. (C) 1997 by The Society of Thora cic Surgeons.