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Improved Postoperative Pulmonary Function

John H. Lemmer, Jr, MD; Mark N. Gomez, MD; Tommy Symreng, MD; Alan F. Ross, MD; Nicholas P. Rossi, MD

Arch Surg. 1990;125(7):873-877.

Abstract
• A prospective randomized controlled study was designed to determine differences in early postoperative pulmonary function, pain, and complications between patients undergoing limited lateral muscle-sparing thoracotomy and those undergoing standard posterolateral thoracotomy. Fifteen patients underwent standard thoracotomy and 13 underwent limited incision with the same anesthetic technique. During the first 24 hours after operation, there were large decreases in the results of spirometric tests of pulmonary reserve (forced expiratory volume in 1 second and forced vital capacity), but these decrements were consistently significantly smaller in the limited-incision group. Other tests of pulmonary function (mid-expiratory phase forced expiratory flow, alveolar-arterial oxygen gradient, and Paco₂), however, demonstrated similar postoperative changes in both groups. Similarly, there were no differences in pain scores, postoperative morphine requirements, complications, or length of hospital stay. Use of the limited muscle-sparing incision resulted in improved postoperative pulmonary reserve, but this did not translate into differences in other measures of postoperative convalescence.

(Arch Surg. 1990;125:873-877)

Author Affiliations
From the Division of Cardiothoracic Surgery, Department of Surgery (Drs Lemmer and Rossi) and the Department of Anesthesiology (Drs Gomez, Symreng, and Ross), University of Iowa College of Medicine, Iowa City.

Footnotes
Accepted for publication March 9, 1990.

Read before the 97th Annual Meeting of the Western Surgical Association, St Louis, Mo, November 15, 1989.

Reprint requests to Division of Cardiothoracic Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, 1613 JCP, Iowa City, IA 52242 (Dr Lemmer).

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