Association between recovery from desaturation after stair climbing and postoperative complications in lung resection.

Objective: The stair-climbing test (SCT) is used as a surrogate for cardiopulmonary exercise testing, which measures maximal oxygen uptake, and considered a useful method for assessing exercise capacity in thoracic surgery. This study aims to investigate whether the recovery time of percutaneous oxygen saturation (SpO) after stair climbing is a predictor of postoperative complications after lobectomy.

Methods: We retrospectively identified 54 patients who performed SCT and underwent lobectomy between January 2015 and February 2023 at Shizuoka Cancer Center. The SpO recovery time was defined as the time required to recover from the minimum to resting value after stair climbing. The association between SpO recovery time and early postoperative pulmonary complications within 30 days after surgery was analyzed.

Results: Eleven patients (20.4%) had postoperative pulmonary complications (≥ Clavien-Dindo Classification Grade 2). The cutoff value of SpO recovery time obtained from the receiver operating characteristic curve analysis was 90 s [sensitivity, 81.8%; specificity, 72.1%; AUC, 0.77 (95% confidence interval, 0.64-0.90)]. The occurrence of postoperative pulmonary complications was 42.9% in the delayed recovery time (DRT; SpO recovery time ≥ 90 s) group and 6.1% in the non-DRT (SpO recovery time < 90 s) group (p = 0.002). DRT was a predictor of postoperative pulmonary complications (odds ratio, 11.60; 95% CI 2.19-61.80).

Conclusions: DRT of SpO after stair climbing is a predictor of postoperative pulmonary complications following lobectomy in borderline patients who require exercise capacity assessment. SpO monitoring after stair climbing may be useful as one of the preoperative assessments in patients undergoing lobectomy.