Effect of abdominal obesity on lung function in the perioperative period of complete video-assisted thoracoscopic lobectomy / 中国医师进修杂志

ABSTRACT

Objective To observe the effect of abdominal obesity on lung function in the perioperative period of complete video-assisted thoracoscopic lobectomy.Methods Collected 36 cases of peripheral lung cancer and could complete video-assisted thoracoscopic lobectomy by access conditions,18 cases in abdominal obesity group who had body mass index (BMI) ＞ 35 kg/m2 and the waist circumference ＞ 95 cm on men the waist circumference ＞ 90 cm on women,18 cases in normal weight group who had BMI ＜ 25 kg/m2 and the waist circumference ＜ 85 cm on men the waist circumference ＜ 80 cm on women.All cases had complete video-assisted thoracoscopic lobectomy and lymph node dissection with 4 holes,and recorded the operation time,before and after operation had blood gas analysis and lung function,at the same time recorded the cases of complication after operation,compared the parameters in two groups.Results The blood gas analysis had no difference before operation,but after 12 h of operation,the arterial blood oxygen partial pressure (PaO2) declined and alveolar-arterial blood oxygen partial pressure difference(PA-aO2) increased in abdominal obesity group,while the PaO2 declined and arterial blood CO2 partial pressure (PaCO2),PA-aO2 increased compared with normal weight group(P ＜ 0.05).The forced vital capacity (FVC),forced expiratory volume in 1 second(FEV1) had statistical significance in two groups before operation(P ＜ 0.05),on the third day after operation,the abdominal obesity group to himself the FVC,FEV1,maximal voluntary rentilation (MVV),functional residual capacity (FRC),carbon monoxide diffusion amount (DLCO) declined obviously except FEV1/FVC (P ＜ 0.05),compared with normal weight group,the FVC,FEV1,FRC,DLCO declined obviously (P ＜ 0.05).After operation,the lung function in abdominal obesity group,the FVC,FEV1,MVV,FRC,DLCO declined 25.8％,27.8％,20.4％,32.1％,39.1％,compared with normal weight group the FVC,FEV1,FRC,DLCO declined 31.8％,37.2％,30.2％,30.6％.The abdominal obesity group had more complication.Conclusion In the perioperative period of complete video-assisted thoracoscopic lobectomy,the abdominal obesity has more effect to lung function and must have more attentions on it,and effective weight control has important significance to operation patients.