Chair and Department of Thoracic Surgery, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland.
Department of Biomaterials and Medical Devices Engineering, Faculty of Biomedical Engineering, Silesian University of Technology, Zabrze, Poland.
PLoS One. 2022 Aug 31;17(8):e0273641. doi: 10.1371/journal.pone.0273641. eCollection 2022.
Many diseases and conditions can alter an ability to maintain body balance. The aim of the present study was to investigate whether thoracic surgery may elicit diaphragm dysfunction thereby impairing postural stability. 40 patients qualified to video-assisted thoracoscopy (VATS) lobectomy or lobectomy via thoracotomy due to pulmonary carcinoma were examined two times: a day before lung resection and 3-5 days after surgical procedure. Diaphragm assessment was performed using ultrasonography, while postural sways were evaluated by Zebris FDM-S stabilometric platform. Thoracic surgery was associated with decrease of diaphragm thickness and movement, as well as, with deterioration of static body balance maintenance. Upper lobe resection was linked with greater diaphragm excursion restriction and worse body sway parameters than middle and lower lobe resection. VATS lobectomy was associated with better postoperative diaphragm function and better postural sway parameters than lobectomy via thoracotomy. Patients after lobectomy via thoracotomy had significantly more load on lower limb on the operated side than patients after VATS lobectomy. Impairment of diaphragm function is closely associated with equilibrium impairment after pulmonary resection. VATS lobectomy was less invasive than lobectomy via thoracotomy in terms of primary respiratory muscle function and body balance maintenance parameters.
许多疾病和状况都会改变维持身体平衡的能力。本研究的目的是探讨胸腔手术是否会引起膈肌功能障碍，从而损害姿势稳定性。40 名符合条件的因肺癌接受电视辅助胸腔镜（VATS）肺叶切除术或开胸肺叶切除术的患者接受了两次检查：肺切除术前一天和手术后 3-5 天。使用超声评估膈肌，使用 Zebris FDM-S 稳定平台评估姿势摆动。胸腔手术与膈肌厚度和运动的减少以及静态身体平衡维持的恶化有关。上叶切除术与中、下叶切除术相比，膈肌运动受限程度更大，身体摆动参数更差。VATS 肺叶切除术与开胸肺叶切除术相比，术后膈肌功能和姿势摆动参数更好。开胸肺叶切除术的患者在手术侧下肢的负荷明显高于 VATS 肺叶切除术的患者。膈肌功能障碍与肺切除术后平衡障碍密切相关。VATS 肺叶切除术在原发性呼吸肌功能和身体平衡维持参数方面比开胸肺叶切除术的创伤更小。
