Evaluation of respiratory muscle strength, diaphragmatic thickness and functional exercise capacity in lobectomy surgeries with thoracotomy and VATS

The most commonly treatment for early stage non-small cell lung cancer (NSCLC) is lobectomy. Different surgical interventions during lobectomy are thought to have different effects on respiratory functions and exercise capacities. The aim of this study was to evaluate respiratory muscle strength, functional exercise capacity, and diaphragmatic thickness in groups that underwent lobectomy with standard thoracotomy, muscle sparing thoracotomy, and video-assisted thoracic surgery (VATS). Forty two individuals, 57% male, between the ages of 18-72 were included in the study. Respiratory muscle strength was measured by measuring mouth pressure and using maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values. 6-minute walk test (6MWT) was used to evaluate functional exercise capacity. Ultrasound was used to measure diaphragmatic thickness. Evaluations done on the day before surgery and 15-20 days after discharge. After surgery, 6MWT distances, MIP-MEP values and surgical side end-inspiratory diaphragmatic thickness was significantly lower than before surgery (p<0.05). The percentage of change in 6MWT distance and MIP-MEP values of the VATS group was significantly higher than the standard thoracotomy group (p<0.017). VATS is a superior method in terms of preserving respiratory muscle strength and functional exercise capacities compared to standart thoracotomy in lobectomies performed in patients with lung cancer. The importance of exercise capacity and respiratory muscle strength parameters should be considered in patients who will undergo lobectomy. Our study will guide the pulmonary rehabilitation programs to be planned before and after surgery.