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Related Experiment Videos

Pulmonary function evaluation of the lung resection candidate: a prospective study.

G N Olsen, A J Block, E W Swenson

    The American Review of Respiratory Disease
    |April 1, 1975
    PubMed
    Summary

    Preoperative split pulmonary function testing identifies operable lung cancer patients with abnormal screening results. This method enables surgical intervention for those previously deemed inoperable, improving survival rates.

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    Area of Science:

    • Thoracic Surgery
    • Pulmonary Medicine
    • Oncology

    Background:

    • Preoperative pulmonary function abnormalities predict poor outcomes after lung surgery.
    • Identifying operable patients with lung masses and compromised pulmonary function is challenging.

    Purpose of the Study:

    • To evaluate the utility of split pulmonary function testing (SPFT) in selecting patients with lung masses and abnormal screening pulmonary function for thoracotomy.
    • To assess the cardiorespiratory morbidity and mortality associated with pneumonectomy and lobectomy in this high-risk group.

    Main Methods:

    • Fifty-six patients with lung masses and abnormal screening pulmonary function underwent SPFT using temporary unilateral pulmonary artery occlusion and quantitative lung scanning.
    • Patients were offered surgery if their non-cancerous lung had a forced expiratory volume in 1 second (FEV1) > 800 ml and adequate circulatory reserve.

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    Main Results:

    • Six patients were deemed physiologically inoperable; 8 others were not offered or refused surgery.
    • Forty-two patients underwent exploration, with 30 undergoing resection (17 pneumonectomy, 13 lobectomy).
    • Cardiorespiratory mortality was 17.6% for pneumonectomy and 7.7% for lobectomy, lower than historical controls. 59% survival at 1-3 years post-resection.

    Conclusions:

    • SPFT allows for the selection of high-risk patients with lung masses for surgical resection.
    • This preoperative assessment can identify patients suitable for thoracotomy who might otherwise be excluded based on standard evaluations.
    • SPFT can lead to improved survival outcomes in carefully selected patients with significant pulmonary impairment.