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J Thorac Cardiovasc Surg 2007;134:1273-1278
© 2007 The American Association for Thoracic Surgery


General Thoracic Surgery

Long-term recovery of exercise capacity and pulmonary function after lobectomy

Yoshinori Nagamatsu, PhDa,*, Kanetaka Maeshiro, MDa, Norman Y. Kimura, MDa, Tatsuya Nishi, MDa, Ichirou Shima, PhDb, Hideaki Yamana, PhDc, Kazuo Shirouzu, PhDc

a Department of Surgery, National Hospital Organization Omuta National Hospital, Ohmuta Fukuoka, Japan
b Department of Surgery, Saiseikai Yahata General Hospital, Kitakyushu Fukuoka, Japan
c Department of Surgery, Kurume University, School of Medicine, Kurume Fukuoka, Japan.

Received for publication February 20, 2007; revisions received June 8, 2007; accepted for publication June 14, 2007.

* Address for reprints: Yoshinori Nagamatsu, PhD, Department of Surgery, National Hospital Organization Omuta National Hospital, 1044-1 Tachibana Ohmuta City, 837-0911 Japan. (Email: nagam2{at}nifty.com).

Objective: The objective of the present study was to perform longitudinal objective evaluations of recovery of exercise capacity based on expired gas analysis during exercise testing up to 1 year after pulmonary resection.

Methods: The study included 18 patients who underwent lobectomy. Expired gas analysis during exercise testing was conducted 1 week before surgery and 2 weeks, 1 month, 3 months, 6 months, and 1 year after surgery. The parameters studied included maximum exercise capacity based on expired gas analysis during exercise testing (maximum oxygen uptake per minute per square meter of body surface area) and assessment of moderate exercise capacity (anaerobic threshold per square meter of body surface area). The changes in postoperative data relative to the preoperative values (baseline) were assessed, including the percent changes from baseline data, which were arbitrarily given a value of 100.

Results: Maximum oxygen uptake per minute per square meter of body surface area decreased significantly to 78.6% ± 14.2% of the baseline value at 2 weeks after surgery and was 80.3% ± 12.7%, 90.9% ± 15.9%, 90% ± 19.7%, and 97% ± 4.8% of the baseline value at 1, 3, and 6 months, and 1 year, respectively. Anaerobic threshold per square meter of body surface area reached 91.1% ± 17.5% of the baseline value even 2 weeks after surgery and was 87.1% ± 17.3%, 97.5% ± 28.0%, 84.3% ± 13.2%, and 104% ± 16.2% of the baseline value at 1, 3, and 6 months, and 1 year, respectively.

Conclusion: The extent of recovery of exercise capacity at 1 year after surgery was approximately 95%. Furthermore, the anaerobic threshold per square meter of body surface area was restored to the preoperative level by 1 year after surgery.



Abbreviations and Acronyms AT/m2 = anaerobic threshold per square meter; COPD = chronic obstructive pulmonary disease; FEV1.0/m2 = forced expiratory volume in 1.0 second per square meter; FVC/m2 = forced vital capacity per square meter; %VC = percent vital capacity; Vo2max/m2 = maximum oxygen uptake per minute per square meter








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