A retrospective study of diaphragmatic motion, pulmonary function, and quality-of-life following video-assisted thoracoscopic lobectomy in patients with nonsmall cell lung cancer

Indian J Cancer. 2015 Feb:51 Suppl 2:e45-8. doi: 10.4103/0019-509X.151991.

Abstract

Background: Diaphragmatic dysfunction and its negative physiologic disadvantages are less commonly reported in patients with lung cancer video-assisted thoracoscopic lobectomy. The aim of this study was to investigate the outcomes of this complication on pulmonary function and quality-of-life in patients following video-assisted thoracoscopic lobectomy.

Objectives: The aim of this study was to investigate potential benefits on pulmonary function and quality-of-life with normal diaphragmatic motion.

Materials and methods: A retrospective study was conducted in 64 patients with nonsmall cell lung cancer after video-assisted thoracoscopic lobectomy. The population were divided into groups 1 (with diaphragmatic paralysis, n = 32) and group 2 (without diaphragmatic paralysis, n = 32) according diaphragmatic motion after postoperatively 6 months. And then, we investigated the difference between the two groups on pulmonary function and quality-of-life.

Results: (1) At 6 months after resection, the patients in group 1 had lost 25% of their preoperative forced expiratory volume in the 1 s (FEV 1 ) (P < 0.001), and the patients in group 2 had lost 15% of their preoperative FEV 1 (P < 0.001). And the other spirometric variables in group 1 were significantly worse than that of group 2 (P < 0.001). (2) The most frequently reported postoperative symptoms were fatigue, coughing, dyspnea, and thoracotomy pain in two groups. Of all the symptom scales, only the dyspnea scale showed a significant difference which subject has a higher proportion and scale compared to control.

Conclusions: The present study indicates that unilateral diaphragmatic paralysis following video-assisted thoracoscopic lobectomy caused adverse effects on postoperative pulmonary function and quality-of-life.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Diaphragm / physiopathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Length of Stay
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymph Node Excision*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Period
  • Prognosis
  • Quality of Life*
  • Respiratory Function Tests
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted / methods*