Is Spirometry a Sufficient Test for Assessing Respiratory Function after Lung Resection?

TL;DR

This study shows that spirometry alone may not fully capture respiratory changes after lung surgery, as the 6-minute walk test shows different trends.

Contribution

The study compares spirometry and 6MWT results pre- and post-surgery to evaluate their effectiveness in assessing respiratory function.

Findings

FEV1 decreased significantly 30 days post-surgery but less than expected.

The 6MWT distance slightly increased three months after surgery.

Spirometry may not fully reflect functional recovery after lobectomy.

Abstract

Background: The prediction of postoperative functional status in non-small cell lung cancer patients based on preoperative assessment of physical and respiratory capacity is inadequate based on recent RCTs. Material and methods: Prospectively collected spirometry data and the six-minute walk test results of 57 patients treated with lobectomy for non-small cell lung cancer were analyzed. The tests were performed before surgery, and 30 and 90 days after lobectomy. All patients underwent a respiratory functional and physical capacity assessment. Results: All 57 patients underwent lobectomy. Before surgery, mean FEV1 was 2.4 ± 0.7 L, corresponding to %FEV1 of 88.3 ± 17.3%. The mean absolute and expected 6MWT distance was 548 ± 74.6 m and 108.9 ± 14.5%, respectively. At the first postoperative evaluation 30 days after surgery, FEV1 and %FEV1 decreased significantly by an average of 0.5 ± 0.3 L and 15.1 ± 10.7%, while 6MWT and expected 6MWT decreased minimally by an average of 1.0 m and 0.8%, respectively. Three months after lobectomy, FEV1 and %FEV1, compared with the initial assessment, decreased by an average of 0.3 ± 0.3 l and 7.8 ± 10.0%, while 6MWT and its expected score increased to 564.6 ± 84.6 m and 112.8 ± 15.8%, respectively. Conclusions: After lobectomy, FEV1 decreased slightly and less than expected, while 6MWT increased proportionally compared to the preoperative evaluation.

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