A retrospective study of diaphragmatic motion, pulmonary function, and quality-of-life following video-assisted thoracoscopic lobectomy in patients with nonsmall cell lung cancer.

ABSTRACT

BACKGROUND: Diaphragmatic dysfunction and its negative physiologic disadvantages are less commonly reported in patients with lung cancer video‑assisted thoracoscopic lobectomy. The aim of this study was to investigate the outcomes of this complication on pulmonary function and quality‑of‑life in patients following video‑assisted thoracoscopic lobectomy. OBJECTIVES: The aim of this study was to investigate potential benefits on pulmonary function and quality‑of‑life with normal diaphragmatic motion. MATERIALS AND METHODS: A retrospective study was conducted in 64 patients with nonsmall cell lung cancer after video‑assisted thoracoscopic lobectomy. The population were divided into groups 1 (with diaphragmatic paralysis, n = 32) and group 2 (without diaphragmatic paralysis, n = 32) according diaphragmatic motion after postoperatively 6 months. And then, we investigated the difference between the two groups on pulmonary function and quality‑of‑life. RESULTS: (1) At 6 months after resection, the patients in group 1 had lost 25% of their preoperative forced expiratory volume in the 1 s (FEV1) (P < 0.001), and the patients in group 2 had lost 15% of their preoperative FEV1 (P < 0.001). And the other spirometric variables in group 1 were significantly worse than that of group 2 (P < 0.001). (2) The most frequently reported postoperative symptoms were fatigue, coughing, dyspnea, and thoracotomy pain in two groups. Of all the symptom scales, only the dyspnea scale showed a significant difference which subject has a higher proportion and scale compared to control. CONCLUSIONS: The present study indicates that unilateral diaphragmatic paralysis following video‑assisted thoracoscopic lobectomy caused adverse effects on postoperative pulmonary function and quality‑of‑life.