Aerob kapasitet, lungefunksjon og aktivitetsnivå hos lungekreftpasienter operert ved video-assistert torakoskopi vs torakotomi kirurgi: en prospektiv studie

Abstract

Background: Video-assisted thoracoscopic surgery (VATS) is gaining popularity as a technique for performing lobectomy in lung cancer. Those patients undergoing VATS have shown to have lesser pain, shorter hospital stay, lesser blood loss and better pulmonary function postoperatively than those patients that have undergone thoracotomy. We have not been able to find any study that has compared these surgery methods in relation to changes in oxygen uptake and physical activity level in patients undergoing lung cancer surgery. The aim of the study was therefore to compare pulmonary function, cardiorespiratory fitness (VO2max) and physical activity level between VATS and thoracotomy among lung cancer patients. Subjects and Methods: 37 patients (male =13) with non-small lung cancer underwent either VATS (n=10) or open thoracotomy. Pulmonary function and VO2max was measured before and four to six weeks after surgery. In addition, physical activity was measured about six weeks after surgery with Actigraf for seven consecutive days. Mann-Whitney U test was used to examine differences in lung function and VO2max between VATS and thoracotomy. P values of ≤ 0.05 were considered statistically significant. Results: Postoperative had VATS patients significantly lower reduction in forced vital capacity, ventilator capacity and VO2max, respectively 11 % (p=0.04), 16 % (p=0.006) and 15 % (p=0.008). Moreover, the reduction value in FEV1 was on the significance limit (14%, p=0.055). There was no difference in change in diffusion capacity between the groups (27% VATS vs thoracotomy 26 %). VATS patients showed 13 % higher activity levels measured as steps per day and correspondingly higher intensity expressed as counts per minute, although not significant (p=0.448). However, there were large individual differences in activity level in both groups.