Elsevier

The Annals of Thoracic Surgery

Volume 72, Issue 5, November 2001, Pages 1705-1710
The Annals of Thoracic Surgery

Original article: general thoracic
Stair-climbing test to evaluate maximum aerobic capacity early after lung resection

https://doi.org/10.1016/S0003-4975(01)03100-9Get rights and content

Abstract

Background. The aim of this study was to investigate the extent of reduction in maximum oxygen consumption in the early postoperative period after lung resection for lung carcinoma.

Methods. A total of 115 patients who underwent lung resection (95 lobectomies, 20 pneumonectomies) performed a maximal stair-climbing test the day before operation and the day of discharge from the hospital (8 ± 3.3 days after the operation).

Results. The postoperative test showed a 15% reduction in maximum oxygen consumption (V̇o2max) with respect to the preoperative test (Student’s t test, p < 0.0001). This reduction was greater after pneumonectomy (21.4%) than after lobectomy (14%) (Student’s t test, p < 0.05). A multiple regression analysis showed that the only significant independent predictors of both preoperative and postoperative V̇o2max were the age of the patient and the level of arterial oxygen content.

Conclusions. The early postoperative reduction in V̇o2max was greater after pneumonectomy than after lobectomy and the exercise performance was significantly influenced by the level of arterial oxygen content both before and early after the operation.

Section snippets

Material and methods

One hundred twenty candidates for lung resection for non–small cell lung carcinoma from December 1999 through November 2000 were enrolled prospectively in our study after giving informed consent. Five patients were excluded from the analysis (1 died postoperatively; 4 refused to perform the postoperative exercise test). The remaining 115 patients (88 men and 27 women) formed the database of the study. Ninety-five lobectomies and 20 pneumonectomies were performed through a muscle-sparing lateral

Results

The characteristics of the patients enrolled in the study are shown in Table 1. 22 patients developed 25 complications: 11 prolonged air leaks (lasting more than 7 days), 4 pneumonia, 4 atrial fibrillation requiring medical treatment, 2 fever higher than 38°C for longer than 3 days, 1 atelectasis requiring bronchoscopy, 1 pleural empyema, 1 cardiac failure, and 1 pulmonary edema. Those patients experiencing postoperative complications climbed significantly fewer steps in the preoperative test

Comment

Stair climbing has an honored tradition among surgeons who have used it in the past to screen patients for major operations 9, 10. However, few studies have systematically used this type of exercise in the preoperative evaluation of lung resection candidates 7, 11, 12 and none for assessing the postoperative exercise tolerance.

The appeal of stair climbing is its simplicity and the patients’ familiarity with the exercise, and we consistently use this test for risk stratification before

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