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Body weight and nutritional changes after reduction pneumoplasty for severe emphysema: a randomized study
Tommaso Claudio Mineo1, Vincenzo Ambrogi, Eugenio Pompeo
1Division of Thoracic Surgery, Tor Vergata University, La Sapienza University, 00133 Rome, Italy. mineo@med.uniroma2.it
The Journal of Thoracic and Cardiovascular Surgery
|September 27, 2002
Summary
Reduction pneumoplasty significantly improved body weight and nutritional status in severe emphysema patients, unlike respiratory rehabilitation. Gains were linked to increased fat-free mass and reduced lung volume.
Area of Science:
- Pulmonology
- Surgical Interventions
- Nutritional Science
Background:
- The effect of reduction pneumoplasty on body weight and nutritional status in severe emphysema patients remains unquantified in controlled studies.
- Severe emphysema significantly impacts patients' nutritional status and body weight.
Purpose of the Study:
- To investigate the impact of reduction pneumoplasty versus respiratory rehabilitation on body weight and nutritional status in severe emphysema patients.
- To determine correlations between surgical outcomes, weight changes, and nutritional markers.
Main Methods:
- A randomized controlled trial involving 60 severe emphysema patients assigned to reduction pneumoplasty (n=30) or 6-week respiratory rehabilitation (n=30).
- Nutritional status assessed via BMI, triceps skin fold, midarm muscle circumference, biochemical values, and bioelectric impedance for fat/fat-free mass.
- Follow-up at 3, 6, and 12 months post-intervention.
Main Results:
- Reduction pneumoplasty group showed significant weight gain (1.82 kg at 3 months, 2.87 kg at 6 months, 3.29 kg at 12 months) compared to the rehabilitation group (-0.57 kg, -1.11 kg, -0.95 kg, respectively).
- Significant improvements in fat-free mass, total proteins, albumin, transferrin, cholesterol, hemoglobin, triceps skin fold, and midarm muscle circumference were observed only in the reduction pneumoplasty group.
- Weight gain in the reduction pneumoplasty group correlated with lower baseline weight and greater residual volume reduction.
Conclusions:
- Reduction pneumoplasty leads to significant improvements in body weight and nutritional status in severe emphysema patients, primarily through fat-free mass accretion.
- Respiratory rehabilitation alone did not yield significant improvements in nutritional indices.
- Postoperative weight gain after reduction pneumoplasty is associated with improved lung function, specifically reduced residual volume.