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Exercise capacity after lobectomy in patients with chronic obstructive pulmonary disease

Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, 840, Shijo-cho, Kashihara, Nara, 634-8522, Japan

*Corresponding author. Tel.: +81-744-22-3051; fax: +81-744-24-8040.

E-mail address: mdkeiji{at}m3.kcn.ne.jp (K. Kushibe).

The aim of this study is to clarify whether patients with chronic obstructive pulmonary disease (COPD) lose less exercise capacity after lobectomy than do those without COPD, to the same extent as ventilatory capacity and lobectomy for selected patients with severe emphysema improve exercise capacity like ventilatory capacity. Seventy non-COPD patients (N group), 16 mild COPD patients (M group), and 14 moderate-to-severe COPD patients (S group) participated. Pulmonary function and exercise capacity tests were performed on the same day preoperatively and six months to one year after lobectomy. The S group lost significantly less FEV₁ (forced expiratory volume in 1 s) after lobectomy than did the N or M group (P<0.0001 and P<0.005). However, their loss of exercise capacity was equivalent to that for the N and M groups. For the S group, there was a significant, negative correlation between preoperative FEV₁ % of predicted and percentage change in FEV₁ and maximum oxygen consumption (VO_{2 max}) after lobectomy (r=–0.93, P<0.0001 and r=–0.64, P=0.01). In moderate-to-severe COPD patients, patients with a lower preoperative FEV₁ % of predicted experienced a smaller decrease in FEV₁ and VO_{2 max} after lobectomy.

Key Words: Lung cancer; Exercise capacity; Lobectomy; Chronic obstructive pulmonary disease

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