Segmentectomy versus lobectomy: does FEV1.0 change accurately reflect the postoperative cardiopulmonary function?

Area of Science:

• Thoracic Surgery
• Pulmonary Function Testing
• Cardiopulmonary Physiology

Background:

• Previous studies compared postoperative respiratory function after lobectomy and segmentectomy using static spirometry.
• Static spirometry may not fully reflect dynamic cardiopulmonary function.
• The utility of the 6-minute walk test in assessing functional changes post-lung resection is under investigation.

Purpose of the Study:

• To compare postoperative cardiopulmonary function between lobectomy and segmentectomy using spirometry and the 6-minute walk test.
• To evaluate dynamic changes in heart rate, respiratory rate, and oxygen saturation during exercise.
• To determine if segmentectomy offers better preservation of cardiopulmonary function compared to lobectomy.

Main Methods:

• Patients undergoing lobectomy (n=21) or segmentectomy (n=24) were assessed.
• Spirometry was used to measure forced expiratory volume in 1 second (FEV1.0).
• The 6-minute walk test evaluated changes in heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2) before and after walking.

Main Results:

• No significant difference in FEV1.0 reduction was observed between the groups.
• Post-exercise HR and RR increases showed no significant difference between lobectomy and segmentectomy.
• A significant reduction in SpO2 was observed in the lobectomy group compared to the segmentectomy group (p < 0.001).
• Increased number of resected segments correlated with greater SpO2 reduction (p = 0.002).

Conclusions:

• Segmentectomy significantly suppressed SpO2 reduction during the 6-minute walk test compared to lobectomy.
• Segmentectomy appears to have a lesser impact on cardiopulmonary function post-surgery.
• The 6-minute walk test is a valuable tool for assessing postoperative cardiopulmonary function after lung resection.