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R. Okita



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    P2.07 - Poster Session 2 - Surgery (ID 190)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P2.07-036 - Lower-than-expected FEV1 after upper lobe resection for lung cancer in the early postoperative period (ID 3039)

      09:30 - 09:30  |  Author(s): R. Okita

      • Abstract

      Background
      After pulmonary resection, the immediate postoperative observed forced expiratory volume at 1 second (FEV1) is expected to be more correlated with the incidence of postoperative complications than the postoperative predicted FEV1. However, the clinical factors that affect the decrease in postoperative FEV1 have not been reported in detail.

      Methods
      Seventy patients who underwent lobectomy or segmentectomy for lung cancer were prospectively enrolled in this study. Of these patients, 25 who performed all pulmonary function tests in the preoperative period and in the early (at 3 or 4 days), middle (3 weeks later), and late (> 3 months later) postoperative periods were analyzed. At each postoperative period, the ratio of the postoperative observed FEV1 to the postoperative predicted FEV1 (po/ppFEV1) was evaluated according to the clinical factors.

      Results
      The mean po/ppFEV1 in the early / middle / late postoperative periods in all cases was 0.83 / 1.02 / 1.11. In the early period, the mean po/ppFEV1 of the resected upper / middle/ lower lobes was 0.74 / 0.97 / 0.88. The early poFEV1 after upper lobe resection was significantly lower than the ppFEV1 after middle or lower lobe resection (P=0.019). In the middle and late periods, no significant relationships were found between po/ppFEV1 and the resected lobe. No other clinical factors showed significant relationships with po/ppFEV1 in any postoperative period. The postoperative forced volume capacity (FVC) did not show a significant relationship with any clinical factor.

      Conclusion
      Resection of the upper lobe leads to a decrease of the FEV1 in the early postoperative period that is lower than the postoperative predicted FEV1. Therefore, in the early postoperative period after upper lobe resection, careful management is needed in order to avoid pulmonary complications.