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To determine the effects of reduction mammaplasty on lung function in women with mammary hypertrophy (macromastia), a prospective, randomized, controlled trial was conducted at the Academic Surgery and Plastic Surgery Units, Castle Hill Hospital, Cottingham, United Kingdom.Seventy-three women who were referred for consideration of bilateral breast reduction surgery were randomized into either an early intervention group (surgery within 6 weeks) or a control group (surgery 6 months after recruitment). Each group had two sets of lung function tests: the intervention group had one before and one 3 months after surgery and the control arm had one test initially and a second test 4 months after randomization and before surgery. The main outcome measure was the lung function test.Sixty-five patients completed the study. The mean age was 39 years (SD, 12 years); both groups were equally matched for age, smoking status, social class, and educational status. By independent t test, there was no significant difference in lung function in the two groups. Subgroup analysis of the intervention group demonstrated a positive correlation between specimen weight and forced expiratory volume/vital capacity, forced expiratory volume/forced vital capacity, peak expiratory flow rate, and forced vital capacity. A paired sample t test revealed a significant improvement in the percentage of forced vital capacity performed/forced vital capacity predicted.The improvement in pulmonary function following reduction mammaplasty correlates with specimen weight resected.