Objective

The lung volume reduction effect of lobectomy for lung cancer in COPD patients is widely recognized. The dynamic changes in chest wall mechanics in these patients has not been described.

Methods

5 COPD and 6 Non-COPD patients with suspected lung cancer were recruited to the study. Using a novel chest wall motion analysis technology (Optoelectronic Plethysmography), we measured their chest motion before and after lung resection.

Results

Tidal volume at rest in the COPD group improved 6 months following surgery (0.68 +/- 0.26 L), secondary to an increased contribution of the upper rib cage (18 +/- 5 %) and the diaphragm (6 +/- 2 %),with a reduction in contribution from the abdomen (-23 +/- 6 %) (p <0.05). This contrasts with the findings in the Non-COPD group where there is a reduction in the contribution of the upper rib cage (-3 +/- 6 % ) (fig 1). No significant difference in chest wall motion was seen between VATS and Thoracotomy.

Conclusion

The LVRS like effects of lung resection in COPD patients are associated with significant improvements in chest wall mechanics. This study provides a valuable insight into the mechanism of symptomatic benefits of lung resection in this group of patients.