폐절제술 후 폐기능 변화에 대한 전향적 연구 ( 1 )

Abstract

Objectives: It is important to evaluate the pulmonary reserve after lung resection preoperatively in the decision of operability and extent of resection. The loss of functioning lung or operation itself may precipitate respiratory distress postoperatively, especially in the elderly, or the smokers, and or those who have had other pulmonary diseases. Recently the prediction of the postoperative pulmonary function became possible owing to the combinations of the spirometry and radioisotope lung perfusion scan. We performed this prospective study to evaluate the changes of pulmonary function after lung resection according to the postoperative time. Methods : The routine spirometry and lung perfusion scan were performed preoperatively. Postoperative pulmonary function test was performed at 7 days after operation and 3 months interval prospectively. Results : 1) The immediate postoperative pulmonary function was markedly decreased in both groups and the function was improved closely to its preoperative values 3 months after the operation and then showed a tendency to decrease, 2) The differences in the pulmonary function between two groups were seen only 6 months after operation (p<0.05), but the values of pneumonectomy group seemed to be lower after 3 months without statistical significance. 3) The pulmonary function was increased above the predicted value at 3rd month, similar to it at 6fh to 12th month, and decreased below it after 12 month. 4) The most valuable indices of the pulmonary function after operation were FVC and FEV1. Conclusion : There was no significant differences in postoperative pulmonary function between lobectomy and pneumonectomy group, and the parameters of pulmonary function test was improved to the preoperative value at third month, similar to predicted value at 6th to 12th month in plateau, and decreased thereafter.