Respiratory muscle strength after lung resection with special reference to age and procedures of thoracotomy

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Abstract
Changes in respiratory muscle strength after lung resection wereexamined concerning age and procedures of thoracotomy. Maximum inspiratory(MIP) and expiratory (MEP) mouth pressure were measured before operationand 1, 2, 4, and 12 weeks after operation in 81 patients undergoing lungresection. In 48 patients undergoing pneumonectomy, lobectomy, orsegmentectomy, patients older than 70 showed a significantly lower MIP andMEP before operation and throughout the postoperative period compared toyounger ones (P < 0.01). Furthermore, the older patients showed asignificantly lower percentage of postoperative MIP and MEP 4 weeks afteroperation than the younger ones (P < 0.01). In 31 patients undergoinglung wedge resection, patients undergoing limited thoracotomy (LT) andvideo- assisted thoracic surgery (VATS) showed significantly higherpercentages of postoperative MIP and MEP than those undergoingposterolateral thoracotomy (PLT) 1 and 2 weeks after operation (P < 0.01or 0.05). But there was no significant difference in the values between LTand VATS. We concluded that (1) elderly patients suffered respiratorymuscle weakness before and after operation and their postoperative recoveryof respiratory muscle strength was slower than in younger patients, and (2)VATS and LT resulted in more rapid recovery of respiratory muscle strengththan PLT, but the difference between VATS and LT was not significant.

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