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Thoracic surgery may alter body static balance via diaphragm dysfunction.

Janusz Kocjan1, Bożena Gzik-Zroska2, Katarzyna Nowakowska-Lipiec3

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Thoracic surgery impairs diaphragm function and body balance. Video-assisted thoracoscopy (VATS) lobectomy showed better diaphragm function and balance recovery than open thoracotomy, indicating it is less invasive.

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Area of Science:

  • Pulmonary Medicine
  • Surgical Outcomes
  • Physiology

Background:

  • Body balance is crucial for daily activities.
  • Diseases and surgical interventions can compromise postural stability.
  • Diaphragm dysfunction is a potential consequence of thoracic surgery impacting balance.

Purpose of the Study:

  • To investigate the impact of thoracic surgery on diaphragm function.
  • To assess the effect of thoracic surgery on postural stability.
  • To compare diaphragm function and postural control after video-assisted thoracoscopy (VATS) lobectomy versus thoracotomy.

Main Methods:

  • 40 patients undergoing pulmonary carcinoma resection (VATS lobectomy or thoracotomy) were assessed pre- and post-surgery.
  • Diaphragm function was evaluated using ultrasonography (thickness and movement).
  • Postural sway was measured using a stabilometric platform (Zebris FDM-S).

Main Results:

  • Thoracic surgery led to decreased diaphragm thickness and movement, and worsened static body balance.
  • Upper lobe resections resulted in greater diaphragm excursion restriction and poorer balance compared to middle/lower lobe resections.
  • VATS lobectomy demonstrated superior postoperative diaphragm function and balance outcomes compared to thoracotomy, with less load on the operated limb.

Conclusions:

  • Impaired diaphragm function is closely linked to equilibrium deficits following pulmonary resection.
  • VATS lobectomy is less invasive than thoracotomy concerning diaphragm function and postural stability.
  • Preserving diaphragm function is key for maintaining balance after thoracic surgery.