Factors Affecting Exercise Tolerance in Patients Who Underwent Video-Assisted Thoracoscopic Surgery for Lung Cancer

Background Video-assisted thoracoscopic surgery (VATS) is increasingly being performed instead of open thoracotomy for early-stage lung cancer because of the minimally invasive nature of VATS. In this study, we aimed to identify the factors related to exercise tolerance in patients with lung cancer who underwent VATS. Methods in this study, we included 73 consecutive patients who underwent video-assisted lung lobectomy for lung cancer at Shikoku Cancer Center, Matsuyama, Japan. Clinical parameters like the presence or absence of chronic obstructive pulmonary disease (COPD), operative time, intraoperative bleeding, duration of postoperative drain placement, skeletal muscle mass index, muscle strength, physical activity, and exercise tolerance were assessed. Muscle strength was measured using handgrip strength. Exercise tolerance was measured according to the 6-minute walk distance. Results After surgery, handgrip strength and six-minute walk distance were significantly lower than those observed during the preoperative evaluation of the patients (p < 0.05). Stepwise multiple regression analyses showed that higher postoperative handgrip strength, males, and higher preoperative physical activity had a significant positive effect on postoperative six-minute walk distance (p < 0.05, R² = 0.348). Conclusions Improving postoperative exercise tolerance also requires interventions to increase physical activity before surgery and postoperative interventions that also focus on muscle strength.