| 제목 |
Respiratory Muscle Strengh of the Patients with Lung Cancer after Operation |
| 소속 |
National Health Insurance Service Ilsan Hospital, Department of Physical Medicine and Rehabilitation1, Severance Hospital, Department of Rehabilitation Medicine2, Gangnam Severance Hospital, Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease3, Gangnam Severance Hospital, Pulmonary Rehabilitation Center4 |
| 저자 |
Jun Min Cha1*, Min Chul Ha2, Jang Woo Lee1†, Seong-Woong Kang3,4, Won Ah Choi3,4, Yewon Lee3 |
Introduction
After lobectomy conducted for treatment of the lung cancer, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) are significantly decreased. Decreased respiratory function is related to decrease of exercise capacity and general condition and eventually can lead to delayed functional recovery and intolerance to neoadjuvant chemotherapy or radiotherapy after operation. For surgical resection of the tumor, incision of respiratory muscles, especially external and internal intercostal muscles is inevitable and can cause weakness of these muscles. The objective of this study is investigate the influence of operation for lung cancer on respiratory muscle strength.
Materials and Methods
The patients who suffered from dyspnea on exertion after the surgery for primary lung cancer were recruited in this study. The parameters reflecting respiratory function such as maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), FVC, FEV1, FEV1/FVC, and maximal voluntary ventilation (MVV) were measured by desktop spirometer (Pony Fx®, COSMED, Rome, Italy). All parameters were measured at least three times and maximal values were recorded. MIP, MEP, FVC, FEV1 and MVV were converted to the ratio of normal predictive values. All patients did not receive any neoadjuvant treatment at the time of pulmonary evaluation. The patients with accompanying pulmonary diseases, such as chronic obstructive pulmonary disease, asthma and active pulmonary tuberculosis or other systemic diseases potentially affect muscle strength such as chronic kidney disease and paralysis caused by cerebrovascular disease were excluded. Wheel-chair bonded or tracheostomized patients were also excluded from this study.
Results
A total twelve patients were included in this study. Median age was 73 years and median duration from operation to evaluation of pulmonary function was 1.2 months. Nine patients were diagnosed as adenocarcinoma and the others are diagnosed as squamous cell carcinoma, histologically. Video-assisted thoracoscopic surgery was conducted in 8 patients and thoracotomy was fulfilled in the others (Table 1). Median percentage of the normal predictive values of MIP and MEP were 92% and 89% respectively. However FVC, FEV1 and MVV were all below than 70% of the normal predictive values (Table 2 and Fig. 1).
Conclusion
In this study, after operation for the lung cancer, respiratory muscle strength is relatively preserved compared with the respiratory parameters related to lung volume and airflow. |
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Table 1. Demographic characteristics of participants
Table 2. The results of the parameters of pulmonary function
Fig 1. The box plots of the parameters of pulmonary function
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