Bronchodilators are essential for the perioperative management of patients with
chronic obstructive pulmonary disease (
COPD) undergoing surgery for
lung cancer. The objective of the present study was to examine whether the usage of a long-acting β2-agonist (LABA) with a long-acting
muscarinic antagonist (LAMA) could optimize preoperative lung function and reduce the risk for postoperative pulmonary complications. Thirty-two consecutive patients with moderate-to-severe
COPD who underwent a lobectomy for
lung cancer and received preoperative LAMA (n=19) or LAMA/LABA (n=13)
therapy between January 2005 and December 2015 were enrolled in this retrospective study. The improvement of preoperative pulmonary function and the postoperative morbidity were compared between the patients with preoperative LAMA, and LAMA/LABA
therapy. Increases in the forced expiratory volume in one second (FEV1) were significantly larger in the LAMA/LABA group than in the LAMA group (0.26±0.05 l vs. 0.07±0.05 l; P=0.0145). More patients in the LAMA/LABA group than in the LAMA group showed a marked improvement of >10% in %FEV1 after
bronchodilators (85 vs. 32%; P=0.0046). The incidence of postoperative
pneumonia was significantly lower in the LAMA/LABA group than in the LAMA group (0 vs. 26%; P=0.044). In conclusion, the present study showed that preoperative LAMA/LABA
therapy was associated with larger improvements in preoperative pulmonary function and less postoperative
pneumonia than LAMA
therapy. These results may lead to greater improvements in FEV1 and less postoperative
pneumonia by encouraging preoperative LAMA/LABA
therapy in this patient population.