Department of General Thoracic and Cardiovascular Surgery, University of Toyama, Toyama, Japan
Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–C
Chronic obstructive pulmonary disease (COPD) may influence higher symptoms, mortality and mobility risk after lung resection. The first choice treatment for COPD is a long acting bronchodilators, and which may improve lung function, alleviate symptoms, and reduce complication rates. We designed this study to assess efficacy of the perioperative, inhaled bronchodilators for pulmonary resection in lung cancer patients with untreated COPD.
We reviewed the clinical records of the 123 lung cancer patients with untreated COPD from 2011 to 2017. Demographics and outcome were compared between the two groups; untreated versus treatment group. Patients in the treatment group were received long-acting muscarinic antagonist beta-agonist combination before lung resection. At each subsequent pre-dose, 2 weeks-dose before surgery, and 3 months after surgery spirometry was done.
85 (69.1%) patients took inhaled bronchodilators before surgery. In the treatment group, the median trough forced expiratory volume in 1 s (FEV1) at 2 weeks after inhalation improved 120 ml (-0.47-0.59), and 6 of them (7.1%) were permitted radical resection. Compared with untreated patients, the treatment group had shorter drainage (1 vs 3, p<0.0001), shorter hospital durations (7 vs 9, p=0.018) and statistically significant differences between postoperative predicted FEV1 and actual FEV1 at 3 months after surgery (0.33 vs. 0.037 L, p<0.001). Patient characteristics, COPD grades, surgical procedure, complications, and incidence of adverse events were similar between the two groups.
Preoperative inhaled long-acting muscarinic antagonist beta-agonist in lung cancer patients with untreated COPD could provide appropriate treatment and better postoperative management.