Pulmonary function after lobectomy: Video-assisted thoracic surgery versus thoracotomy

Background. Whether video-assisted thoracic surgery (VATS) improves postoperative pulmonary function is stilt controversial. We compared postoperative pulmonary function after VATS lobectomy and standard lobectomy. Methods. Eleven patients who had undergone standard lobectomy and 10 patients who had undergone VATS lobectomy were studied. Arterial blood gas analyses were performed on the 4th, 7th, and 14th postoperative days. Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1.0), and peak flow rate (PFR) were measured on the 7th and 14th Postoperative days (early phase), and approximately 1 year after surgery (late phase). Results. Pulmonary function, as assessed with arterial oxygen partial pressure (PaO2) (p = 0 054), arterial oxygen saturation (O-2SAT) (p = 0.063), FVC (P = 0.10), and FEV1.0 (p = 0.08), was better after VATS lobectomy than after thoracotomy on the 7th postoperative day. PFR was significantly better after VATS on both the 7th and 14th postoperative days (p = 0.008 and p = 0.03, respectively). Conclusions. VATS lobectomy had advantages on early postoperative pulmonary function. We conclude that VATS lobectomy is a beneficial alternative to standard thoracotomy, especially for patients with poor pulmonary reserve. (Ann Thorac Surg 2000;70:938-41) (C) 2000 by The Society of Thoracic Surgeons.