Impact of lobectomy on pulmonary function in tubercular patients: a prospective analysis

Rajeebshankar Karmakar; Atik Ahmed Akond; Masnoon Ahmed Noor; Sutopa Halder Supti; Delwar Hossain; Raisa Enayet Badhan

doi:10.18203/2349-3933.ijam20251931

Authors

Rajeebshankar Karmakar 1DGHS, Mohakhali, Dhaka, Bangladesh
Atik Ahmed Akond DGHS, Mohakhali, Dhaka, Bangladesh
Masnoon Ahmed Noor NIDCH, Mohakhali, Dhaka, Bangladesh
Sutopa Halder Supti Department of Paediatric Gastroenterology and Nutrition, BSMMU, Shahbag, Dhaka, Babgladesh
Delwar Hossain Department of Thoracic Surgery, NIDCH, Mohakhali, Dhaka, Bangladesh
Raisa Enayet Badhan Department of Microbiology, National Institution of Burn and Plastic Surgery, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3933.ijam20251931

Keywords:

Lobectomy, Outcome of lobectomy, Pulmonary function test, Tuberculosis

Abstract

Background: Tuberculosis (TB) is a leading cause of death globally, with South Asia bearing a significant burden. In Bangladesh, TB poses major health challenges, especially in rural areas. For patients with TB sequelae, lobectomy may be necessary. Assessing pulmonary function before and after surgery is crucial for understanding the impact on patients. This study aimed to evaluate the changes in pulmonary function in TB patients undergoing lobectomy.

Methods: The study employed a prospective longitudinal design at the National Institute of Diseases of the Chest and Hospital, spanning from January 2022 to June 2023. Thirty patients, aged over 18 years and capable of undergoing spirometry, were enrolled. These patients had diagnoses including post-tuberculous sequelae, were scheduled for lobectomy. Data were collected through interviews and lung function tests conducted before and two months post-surgery. Statistical analyses were performed using SPSS version 29.

Results: The study included 30 patients with an average age of 37.77 years, predominantly male (73.33%). Significant reductions in pulmonary function were observed post-lobectomy: the mean Forced Expiratory Volume in the first second (FEV1) decreased from 1.82 liters to 1.56 liters postoperatively (p=0.034) and the mean Forced Vital Capacity (FVC) dropped from 2.28 liters to 1.91 liters (p=0.005). The FEV1/FVC ratio decreased slightly from 76.67% to 73.37%.

Conclusions: Lobectomy in patients with TB results in significant declines in pulmonary function, as indicated by reductions in FEV1 and FVC post-surgery.

Metrics

Metrics Loading ...

References

Basnyat B, Caws M, Udwadia Z. Tuberculosis in South Asia: a tide in the affairs of men. Multidisciplinary Respir Med. 2018;13:1-8. DOI: https://doi.org/10.1186/s40248-018-0122-y

Hossain S, Quaiyum MA, Zaman K, Banu S, Husain MA, Islam MA, Cooreman E, Borgdorff M, Lönnroth K, Salim AH, van Leth F. Socio economic position in TB prevalence and access to services: results from a population prevalence survey and a facility-based survey in Bangladesh.

World Health Organization. Global tuberculosis report 2023. Geneva: WHO. 2023. Available at: https://www.who.int/teams/global. Accessed on 21 December 2024.

Pomerantz BJ, McCaffrey TV, Pairolero PC, Trastek VF, Deschamps C, Allen MS. Surgical treatment of pulmonary tuberculosis in the modern era. Ann Thorac Surg. 1996;61(4):1205–10.

Rajagopalan S. The role of surgery in the treatment of pulmonary tuberculosis. Indian J Chest Dis Allied Sci. 2014;56(3):189–93.

Meacci E, Lo Iacono G, Nachira D, Zanfrini E, Margaritora S. Surgical treatment of pulmonary tuberculosis: indications and results. J Thorac Dis. 2021;13(6):3746–55.

Altorki NK, Yankelevitz DF, Henschke CI. Thoracoscopic surgical treatment of pulmonary tuberculosis. Chest. 1996;109(5):1331–5.

Kim HJ, Kim YT, Kang CH, Sung SW, Kim JH, Lee JH, et al. Surgical treatment of multidrug-resistant tuberculosis: outcomes and prognostic factors. J Thorac Cardiovasc Surg. 2007;134(3):630–6.

Abascal RH, Garzon AA, Rodriguez M. Surgery for pulmonary tuberculosis in the antibiotic era. J Thorac Cardiovasc Surg. 1997;114(3):483–8.

Macek M, Bednárová J, Kocábek T, Macek P. Long-term evaluation of lung function after surgical treatment of post-tuberculous bronchiectasis. Acta Chir Belg. 2004;104(2):185–9.

Bagheri R, Haghi SZ, Afghani R, Salehi M, Hashemzadeh S. Lung resection in patients with pulmonary tuberculosis: analysis of indications and postoperative outcomes. Interact Cardiovasc Thorac Surg. 2010;11(4):469–72.

Amorim C, Saad R, Stirbulov R. Evaluation of pulmonary function in patients undergoing pulmonary resection. J Bras Pneumol. 2013;39(4):429–36.

Berend N, Woolcock AJ, Marlin GE. Lung function after lobectomy: a follow-up study. Thorax. 1980;35(10):731–6. DOI: https://doi.org/10.1136/thx.35.2.145

Amorim C, Saad Jr. R, Filho RB. Postoperative pulmonary function after lung resection. Rev Col Bras Cir. 2013;40(4):287–92. DOI: https://doi.org/10.1590/S0100-69912013000200006

Chen YY, Wang W, Chen L, Li H, Jin R, Zhao Y. Surgical treatment of multidrug-resistant pulmonary tuberculosis: a retrospective analysis of 205 cases. Thorac Cardiovasc Surg. 2012;60(5):362–7.

Altorki NK, Yankelevitz DF, Henschke CI. Thoracoscopic surgical treatment of pulmonary tuberculosis. Chest. 1996;109(5):1331–5.