초록접수 현황
| 15F-131 | 구연 발표 |
Pulmonary Function Changes over Two Year after Major Pulmonary Resection in Lung Malignancy
한국남, 김현구, 이현주, 최영호
고려대학교 의과대학 구로병원 흉부외과학교실
Background : Pulmonary function tests are one of the postoperative prognostic factors after major lung resection. We aimed to measure the serial changes in pulmonary function over 24 months after major lung resection whether pulmonary function would continue to improve based on our previous 1-year follow-up result.
Methods : In 155 patients who had performed lobectomy or greater with more than 24 months follow-ups, we analyzed the serial changes of forced vital capacity, forced expiratory volume per 1 seconds (FEV1), diffusion capacity of carbon monoxide (DLCO) by existence of chronic obstructive pulmonary disease (COPD), adjuvant chemotherapy, and minimally invasive thoracoscopic surgery (VATS).
Results : The preoperative FEV1% (98.3%) was reduced to mean 76.5 % at postoperative 1 month, and increased to 81.2% by 6months (P<0.001), 82.1% at 1 year (P=0.892), and 79.5% at 2 year (P=0.076). The DLCO% (preoperative 87.5%) was also significantly increased to 78.4% by 6 months (P<0.001), 81.8% at 1 year (P=0.081), and 84.7% at 2 year (P=0.524). There were no significant changes in FEV1% and DLCO% at more than 1-year follow-up. The value of DLCO% in patients with COPD was decreased until postoperative 6 months, but increased to preoperative level by 1-year. The actual level of DLCO% in patients who underwent adjuvant therapy was significantly decreased by 1-year (P=0.052). The VATS lobectomy group showed better improvement of FEV1% and DLCO% compared to those of thoracotomy (P=0.001). The patients who underwent pneumonectomy or bilobectomy showed poor recovery even after 1 year follow-up. The overall changes of FEV1% and DLCO% was not significant at more than 2-year follow-up except VATS group (P=0.005).
Conclusion : The pulmonary functions after lobectomy has continued improvement over 2-year after surgery but it showed minor impact on pulmonary function compared to those of 1-year. Even after 1-year follow-up, the recovery was not significant in patients with chronic obstructive pulmonary disease, and in adjuvant therapy, thoracotomy, bilobectomy or pneumonectomy group.
Methods : In 155 patients who had performed lobectomy or greater with more than 24 months follow-ups, we analyzed the serial changes of forced vital capacity, forced expiratory volume per 1 seconds (FEV1), diffusion capacity of carbon monoxide (DLCO) by existence of chronic obstructive pulmonary disease (COPD), adjuvant chemotherapy, and minimally invasive thoracoscopic surgery (VATS).
Results : The preoperative FEV1% (98.3%) was reduced to mean 76.5 % at postoperative 1 month, and increased to 81.2% by 6months (P<0.001), 82.1% at 1 year (P=0.892), and 79.5% at 2 year (P=0.076). The DLCO% (preoperative 87.5%) was also significantly increased to 78.4% by 6 months (P<0.001), 81.8% at 1 year (P=0.081), and 84.7% at 2 year (P=0.524). There were no significant changes in FEV1% and DLCO% at more than 1-year follow-up. The value of DLCO% in patients with COPD was decreased until postoperative 6 months, but increased to preoperative level by 1-year. The actual level of DLCO% in patients who underwent adjuvant therapy was significantly decreased by 1-year (P=0.052). The VATS lobectomy group showed better improvement of FEV1% and DLCO% compared to those of thoracotomy (P=0.001). The patients who underwent pneumonectomy or bilobectomy showed poor recovery even after 1 year follow-up. The overall changes of FEV1% and DLCO% was not significant at more than 2-year follow-up except VATS group (P=0.005).
Conclusion : The pulmonary functions after lobectomy has continued improvement over 2-year after surgery but it showed minor impact on pulmonary function compared to those of 1-year. Even after 1-year follow-up, the recovery was not significant in patients with chronic obstructive pulmonary disease, and in adjuvant therapy, thoracotomy, bilobectomy or pneumonectomy group.
책임저자: 김현구
고려대학교 의과대학 구로병원 흉부외과학교실
연락처 : 한국남, Tel: 010-4103-9290 , E-mail : hdoccomta@naver.com
