• Hiroaki Nomori, Takashi Ohtsuka, Hirotoshi Horio, Tsuguo Naruke, and Keiichi Suemasu.
• Department of Thoracic Surgery, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo 108-0073, Japan.
• Surg. Today. 2003 Jan 1; 33 (1): 7-12.

PurposePostoperative vital capacity (VC) and the 6-min walking (6MW) test were used to compare the differences in impairment of the pulmonary function and walking capacity in patients undergoing a lobectomy by video-assisted thoracoscopic surgery (VATS), an anterior limited thoracotomy (ALT), an anteroaxillary thoracotomy (AAT), or a posterolateral thoracotomy without muscle sparing (PLT).MethodsThe study was a retrospective analysis. Lung cancer patients who underwent a lobectomy by VATS, ALT, AAT, or PLT (28 in each group) were matched by sex and age (+/-5 years). VC was measured before surgery and at 1, 2, 4, 12, and 24 weeks after surgery. The distance covered during the 6MW test (6MWD) was measured before surgery and in a postoperative test 1 week after surgery.ResultsCompared with the VATS, ALT, and AAT groups, PLT patients showed a significant impairment of VC from 1 to 24 weeks after surgery ( P < 0.05-0.001) and also a significant impairment of 6MWD 1 week after surgery ( P < 0.01-0.001). The AAT group showed a significant impairment of 6MWD 1 week after surgery compared with the VATS and ALT groups ( P < 0.001 and P < 0.05, respectively). There was no significant difference in the impairment of either VC or 6MWD between VATS and ALT.ConclusionsThe PLT without a muscle sparing procedure therefore cannot be recommended for general lung cancer surgery because of the impairment of both walking capacity and pulmonary function which continues long after surgery. VATS and ALT are better procedures than AAT regarding the recovery of walking capacity early after surgery. VATS and ALT are similar to each other regarding the impairment of pulmonary function and walking capacity after surgery.

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