Cardiorespiratory fitness, pulmonary function and activity level in lung cancer patients undergoing VATS vs thoracotomy

Background: Video-assisted thoracoscopic surgery (VATS) is gaining popularity as a technique for performing lobectomy in lung cancer patients, showing lesser pain, shorter hospital stay and lower blood loss compared to patients undergoing traditional thoracotomy. Aim: To compare the change between pre- and post-operative pulmonary function, cardiorespiratory fitness (VO 2max ) and physical activity level in lung cancer patients undergoing VATS and thoracotomy. Methods : 37 patients (male =13), age 35 - 80 with non-small lung cancer underwent either VATS (n=10) or thoracotomy. Measurement of pulmonary function and VO 2max was performed before and four to six weeks after surgery. In addition, physical activity was measured six weeks after surgery with ActiGraph accelerometer for seven consecutive days. Results: There were no differences between the groups before surgery regarding gender, pulmonary function and VO 2max . The average number of segments removed by VATS was 4.4 and thoracotomy 3.8. VATS patients had a significant lower reduction in FVC (9 %, P=0.05), MVV (16 %, P 2max (17 %, P 1 (P=0.06) and DLco (P=0.75). The variation in activity level was large, ranging from 1027 to 13964 steps per day, but there was no difference between the groups (P=0.65). Conclusion : Patients undergoing VATS appear to preserve the vital capacity, ventilatory capacity and VO 2max better than patients undergoing thoracotomy. The number of patients is, however, too small to draw firm conclusions, and should therefore be interpreted with caution.