Preoperative Diaphragm Muscle Atrophy Increases the Likelihood of Postoperative Pulmonary Complications After Lung Cancer Resection: A Pilot Study.

Background/Objectives : Various conditions contribute to the development of postoperative pulmonary complications (PPCs) following thoracic surgery. In this study, the aim was to investigate whether preoperative diaphragm dysfunction is associated with an increased risk of PPCs after lung cancer resection. Methods : We prospectively examined 45 patients scheduled for video-assisted thoracoscopic surgery (VATS) lobectomy or open thoracotomy. Relevant clinical data were retrieved from hospital database records, while diaphragm muscles were assessed using ultrasound. Results : Our results demonstrated that preoperative diaphragm muscle atrophy was significantly associated with a higher risk of developing PPCs compared to patients with normal diaphragm thickness. Diaphragm atrophy was also linked to prolonged hospital stays. Additionally, we observed a moderate correlation between expiratory diaphragm thickness and the number of PPCs. Conclusions : Low diaphragm expiratory thickness is associated with postoperative pulmonary complications after lobectomy for lung cancer. Importantly, unlike other predictive factors such as age, COPD, or smoking, diaphragmatic atrophy is a modifiable risk factor that can potentially be addressed through early therapeutic intervention.