The Role Of Stair Climbing Test In The Preoperative Evaluation Of Patients With Lung Cancer And Lower Pulmonary Function Being Considered For Resectional Surgery

ObjectiveTo assess the role of stair climbing test in the preoperative evaluation of patients with lung cancer and lower pulmonary function being considered for resectional surgery.Materials and Methods418 patients with lung cancer being considered lobectomy underwent spirometry testing, they were divided into two groups: patients with lower pulmonary function(LPF,61 patients with FEV₁%<60%), and patients with normal pulmonary function(NPF,357 patients with FEV₁% ≥ 60%),patients in NPF received lobectomy. Stair climbing test were performed in patients of LPF,surgery were performed in 48 patients who can climb 48 steps(one step is 0.145m in height) in 60s and with SpO₂ > 90%, their clinical state were observed. Patients with lower pulmonary function were divided into two groups: without postoperative cardiopulmonary complication and with postoperative cardiopulmonary complication, clinical characteristics and preoperative pulmonary function were compared between these two groups.Results51 of 405 patients( 12.59%) had cardiopulmonary complications: pneumonia (n=16),arrhythmia(n=14),cardiac failure(n=7), respiratory insufficiency (n=6). atelectasis(n=6),myocardial infarction(n=1),pulmonary embolism(n=1).The risk ofcomplications increased in LPF (11.48%) compared with NPF (20.83%) , but no significant difference between two groups in postoperative morbidity^>0.05). No significant differences in Age, Weight, FEV,%, MVV%, VC%, ppoFEV^time of climbing stair test and SpO2 ( difference in SpC>2 between values at rest and at the end of exercise ) between two groups(P>0.05). The patients without complications had a lower AHR (difference in HR between values at rest and at the end of exercise) compared to patients with complications, they also had a shorter hospital days after surgery(P<0.05).ConclusionsStair climbing test is a simple and economical means to evaluate patients with lung cancer. Some patients who couldn't underwent resectional surgery if assessed by spirometry testing only regain the opportunity of surgery after taking exrcise,selected through stair climbing test.