Perioperative Lung Function Monitoring After Anatomic Lung Resections

Study Overview
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Brief Summary
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Aim of this study was to prospectively investigate the correlation between postoperative spirometry values and pulmonary complications after anatomic lung resections. In addition, the investigators compared postoperative pulmonary function changes between open and minimally invasive approaches.

Detailed Description
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All patients undergoing an anatomical lung resection at the investigators' institution were evaluated for this study. Underage patients and those undergoing extended resections (including resection of the chest wall and/or diaphragm) and/or bronchoplastic procedures were excluded. In every eligible patient undergoing an anatomic lung resection, preoperative spirometry was performed using a handheld spirometer on the day before surgery and on every second day after surgery was performed until patient discharge. The absolute values of FEV1 were recorded by an independent study nurse and noted on a separate sheet not available to the treating doctors. At the end of the study period FEV1 values were evaluated especially with focus on their correlation with postoperative pulmonary complications (i.e. pneumonia, acute exacerbation of COPD, air leak and atelectasis). Furthermore lung function values of patients undergoing 'open' resections were compared with patients undergoing minimally invasive resections.

Official Title
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Perioperative Lung Function Monitoring After Anatomic Lung Resections

Conditions
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Lung Diseases, Lung Function Decreased, Surgery

Intervention / Treatment
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* Diagnostic Test: Spirometry


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients undergoing anatomical lung resection Written informed consent Exclusion Criteria: Underage patients Extended resections including resection of chest wall or diaphragm Bronchoplastic resections

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pneumonia<br>Patients suffering from postoperative pneumonia including all three of the following: Clinical signs of a pulmonary infection (i.e. fever ≥ 38°C combined with productive cough and/or dyspnea) A new rise of inflammatory markers (i.e. WBC count ≥ 10.5 x 109 and elevated CRP) New radiographic infiltrates on chest x-ray without another explanation. Patients with pneumonia undergo spirometry before and on every second day after lung surgery | Diagnostic Test: Spirometry<br>* Absolute FEV1 is measured in every patient using a handheld spirometer<br>|
| No Pneumonia<br>Patients without pneumonia undergo spirometry before and on every second day after lung surgery | Diagnostic Test: Spirometry<br>* Absolute FEV1 is measured in every patient using a handheld spirometer<br>|
| Open (no pneumonia)<br>Patients undergoing open anatomical lung resection who did not show postoperative pneumonia. All patients undergo spirometry before and on every second day after lung surgery. | Diagnostic Test: Spirometry<br>* Absolute FEV1 is measured in every patient using a handheld spirometer<br>|
| Minimally invasive (no pneumonia)<br>Patients undergoing minimally invasive anatomical lung resection who did not show postoperative pneumonia. All patients undergo spirometry before and on every second day after lung surgery. | Diagnostic Test: Spirometry<br>* Absolute FEV1 is measured in every patient using a handheld spirometer<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Decrease in FEV1 | Postoperative loss of FEV1 in percent of absolute preoperative levels | up to 6 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lung resection, lung function, VATS, Thoracotomy