Chest
Clinical InvestigationsPrediction of Postpneumonectomy Pulmonary Function Using Quantitative Macroaggregate Lung Scanning
Section snippets
Materials and Methods
Thirteen patients presenting with bronchogenic carcinoma complicated by signs and symptoms of chronic obstructive airway disease were studied with routine pulmonary function studies. Spirometry before and after administration of isoproterenol was performed and yielded a forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), and maximum voluntary ventilation (MVV). Open-circuit nitrogen washout was performed to determine the functional residual capacity (FRC). With the
Results
The prepneumonectomy, predicted postpneumonectomy and observed postpneumonectomy pulmonary function findings are listed in Table 1. The majority of these patients demonstrate moderate to severe chronic obstructive airway disease. The correlation coefficients between the predicted and observed postoperative pulmonary function values are graphically represented in Figure 1, Figure 2, Figure 3, Figure 4, Figure 5. The correlations are seen to be uniformly positive (r = .617 to .747) and
Discussion
Screening pulmonary functions can indicate those patients at increased risk of postoperative cardiorespiratory insufficiency. The tests have been used by many to exclude those patients with poor function from surgery. If the lung to be removed is contributing little to overall cardiopulmonary function the risks of surgery are less. Considering the overall prognosis of carcinoma of the lung untreated,10 an attempt to offer surgery to more patients seems warranted. The techniques available to
ACKNOWLEDGMENTS
The authors wish to acknowledge the indispensible technical assistance of Ms. Joyce Fencl, Mr. Fred Carey and Mr. Ode E. Cox as well as the secretarial skills of Mrs. Shawn Tomlinson and Mrs. Mary Ann Cobb. We are also extremely grateful to the Department of Radiology, University of Florida, for the use of the radiologic equipment necessary to perform this study.
References (12)
- et al.
Clinical course related to preoperative and postoperative pulmonary function in patients with bronchogenic carcinoma
Chest
(1971) - et al.
A bronchospirometric method estimating the effect of pneumonectomy on the maximum breathing capacity
J Thorac Cardiovasc Surg
(1968) - et al.
Natural course of inoperable lung cancer
Chest
(1973) - et al.
Clinical, physiologic, morphologic examination of the lung in patients with bronchogenic carcinoma and the relation of the findings to postoperative deaths
Am Rev Resp Dis
(1970) - et al.
The role of pulmonary insufficiency in mortality and invalidism following surgery for pulmonary tuberculosis
J Thorac Cardiovasc Surg
(1965) Assessment of operative risk in thoracic surgery
Am Rev Resp Dis
(1961)
Cited by (146)
Prediction of postoperative lung function after major lung resection for lung cancer using volumetric computed tomography
2018, Journal of Thoracic and Cardiovascular SurgeryPreoperative Functional Evaluation of the Surgical Candidate
2018, IASLC Thoracic OncologyApplications of Ventilation-Perfusion Scintigraphy in Surgical Management of Chronic Obstructive Lung Disease and Cancer
2017, Seminars in Nuclear MedicineVibration response imaging versus perfusion scan in lung cancer surgery evaluation
2014, Journal of Thoracic and Cardiovascular SurgerySurgical resection of lung cancer in the elderly
2014, Thoracic Surgery Clinics
Manuscript received December 5; revision accepted February 18.