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Vol.43 No.6 contents

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- Original Article -

Postoperative Exercise Tolerance After Extended Segmentectomy -Analysis Based on a Conventional Treadmill Test-

Hiroaki Harada¹, Wataru Nishio¹, Morihito Okada¹, Toshihiko Sakamoto¹, Kazuya Uchino¹, Kenji Tsuboshima¹, Hidehito Matsuoka², Noriaki Tsubota^1
1Department of General Thoracic Surgery, Hyogo Medical Center for Adults, Japan, ²Department of General Thoracic Surgery, Kaibara Hospital, Japan

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Objective. Since 1992, we have performed limited resection-extended segmentectomy-for patients suspected of having peripheral lung tumors less than 2 cm on chest roentgenograms and with no evidence of metastasis through routine examinations. We already reported that the outcome of extended segmentectomy is comparable to that of lobectomy, and the postoperative functional loss of extended segmentectomy is small. However, controversy about the postoperative functional advantage of limited surgery over standard lobectomy for lung cancer still continues. The aim of this study was to evaluate the extent of reduction of maximal oxygen consumption after extended segmentectomy compared with lobectomy. Patients and Methods. An exercise test was performed preoperatively and two months after surgery to compare the effects of the procedure in 46 patients who underwent extended segmentectomy and 156 who underwent lobectomy. Results. Patients who were treated by extended segmentectomy retained 87.2±0.2% of their preoperative VO₂max/BW, whereas the lobectomy group retained only 78.8±0.1% (p< 0.0001). Also in the analysis for each lobe, the extended segmentectomy group retained significantly better exercise tolerance than the lobectomy group. Conclusions. At several months after surgery, better exercise tolerance was retained in patients who had undergone extended segmentectomy than those who had undergone lobectomy.
key words: Pulmonary resection, Limited resection, Exercise test, VO₂max, Extended segmentectomy

Received: March 14, 2003
Accepted: July 28, 2003

JJLC 43 (6): 705-710, 2003