Recovery of Respiratory Muscle, Physical Functions, and Dyspnea After Lobectomy for Lung Cancer

Abstract Purpose: To characterize respiratory muscle strength, physical functions, and dyspnea in patients receiving pulmonary rehabilitation following lobectomy for non-small cell lung cancer.Methods: This retrospective study included non-small cell lung cancer patients who underwent lobectomy via video-assisted thoracoscopic surgery or posterolateral thoracotomy and pulmonary rehabilitation between September 2013 and March 2018. Maximum mouth inspiratory and expiratory pressures, 6-minute walking distance, quadriceps force, and modified Medical Research Council dyspnea scale score were evaluated before surgery, at discharge, and at post-lobectomy months 1 and 3.Results: Data from 41 eligible patients were analyzed. At discharge, maximum mouth inspiratory and expiratory pressures, 6-minute walking distance, and modified Medical Research Council dyspnea scale score were lower than pre-operative values, but quadriceps force was unchanged. The maximum mouth inspiratory pressure and 6-minute walking distance returned to pre-operative values at post-lobectomy month 1, and maximum expiratory pressure and modified Medical Research Council dyspnea scale score improved at month 3. During sub-analysis, maximum mouth inspiratory pressure and modified Medical Research Council dyspnea scale score after video-assisted thoracoscopic surgery (n = 24) improved to pre-operative levels at post-lobectomy month 1, whereas patients in the posterolateral thoracotomy group (n = 17), it improved at 3 months.Conclusions: After lobectomy for non-small cell lung cancer, patients undergoing pulmonary rehabilitation had their respiratory muscle strength, physical functions, and dyspnea improve to pre-operative levels at post-lobectomy month 3. Moreover, video-assisted thoracoscopic surgery may be more beneficial than posterolateral thoracotomy in the early post-operative recovery of inspiratory muscle strength and dyspnea.