Criteria of Functional Operability in Patients with Bronchial Carcinoma : Preoperative Assessment of Risk and Prediction of Postoperative Function*

Summary

In this prospective study of 433 patients undergoing surgeryfor bronchial carcinoma 3 main factors influencing the operative risk were identified: (1) extent of resection, (2) pulmonary function and (3) age. The 30-day mortality rate was 8.3% in the whole group which comprised a high percentage of patients over 70 years of age (27%) and with a disturbed pulmonary function (45%).

The value of various functional criteria proposed in the extensive literature is assessed and compared with the results of the study in which the use of FEV₁ [1] and quantitative regional analysis by perfusion scanning and 'regions of interest' proved to be highly efficient, allowing, in addition, the prediction of postoperative lung function even in sleeve resections.

A new formula for estimation of the additional loss of function in the early postoperative phase after lobectomies is proposed along with a flow sheet for routine preoperative evaluation of pulmonary function.

Key words

Bronchial Carcinoma - Operability - Quantitative lung scan - 30-day mortality - Early and late postoperative function

1 List of abbreviations:

1 FEV₁ = forced-expiratory 1-second volume

1 RV%/TLC = residual volume in percent of total lung capacity

1 R_aw = airway resitance

1 FEV₁%/VC = FEV₁ in percent of vital capacity

1 PCO₂ - exerc. = PCO₂ during exercise

1 PAP - exerc. = mean pulmonary artery pressure during exercise

1 List of abbreviations:

1 FEV₁ = forced-expiratory 1-second volume

1 RV%/TLC = residual volume in percent of total lung capacity

1 R_aw = airway resitance

1 FEV₁%/VC = FEV₁ in percent of vital capacity

1 PCO₂ - exerc. = PCO₂ during exercise

1 PAP - exerc. = mean pulmonary artery pressure during exercise