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Ann Thorac Surg 1993;55:1477-1484
© 1993 The Society of Thoracic Surgeons

Articles

Cardiopulmonary function after pulmonary lobectomy in patients with lung cancer

Hideki Nishimura, MD*, Masayuki Haniuda, MD, Masami Morimoto, MD, Keishi Kubo, MD

Departments of Surgery and Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Accepted for publication September 22, 1992.

* Address reprint requests to Dr Nishimura, Department of Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390, Japan.

The effects of pulmonary lobectomy on cardiopulmonary function were investigated in 9 patients with lung cancer. Hemodynamic studies at rest and during exercise were performed before and 4 to 6 months after the operation. Differences in hemodynamics between before and after operation were observed with respect to heart rate, pulmonary arterial pressure, pulmonary vascular resistance index, and stroke volume index. Heart rate, pulmonary arterial pressure, and pulmonary vascular resistance index were significantly increased after operation, whereas stroke volume index was significantly decreased. It is thought that cardiac index was preserved by the increase in heart rate despite a decrease in stroke volume index associated with the decreased pulmonary vascular bed after the operation. When driving pressure and cardiac index were studied after operation, the pressure at rest and during exercise was higher, and the pressure-flow curve increased more steeply, as compared with the preoperative values. These results suggest a significant deterioration in cardiopulmonary function after lobectomy. As the patient characteristics were heterogeneous (five lobectomies and four bilobectomies), and their findings are limited, additional studies may be necessary in the future.




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