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Spirometry in surgery for anterior mediastinal masses.
O W Hnatiuk1, P C Corcoran, A Sierra
1Pulmonary and Critical Care Medicine Service, Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. oleh.hnatiuk@na.amedd.army.mil
Chest
|October 10, 2001
Summary
Upright and supine spirometry (USS) for anterior mediastinal masses (AMMs) surgery had limited impact on anesthesia choice or outcomes. Complication rates were low, suggesting USS may not be essential for all AMM patients.
Area of Science:
- Thoracic Surgery
- Anesthesiology
- Pulmonary Medicine
Background:
- Anterior mediastinal masses (AMMs) pose unique surgical challenges.
- Preoperative pulmonary function assessment is crucial for anesthetic planning.
- The utility of upright and supine spirometry (USS) in this context requires further investigation.
Purpose of the Study:
- To evaluate the impact of USS on anesthetic management and perioperative outcomes for AMM surgery.
- To determine if USS findings influence the choice of anesthesia or complication rates.
Main Methods:
- Retrospective cohort study at a tertiary-care military medical center.
- Analysis of 37 patients who underwent surgery for AMMs between 1994 and 2000.
- Inclusion criteria: age >= 18 years, confirmed AMM diagnosis, and available spirometry data.
Main Results:
- USS was ordered in 32.4% and performed in 27.0% of patients.
- USS was more frequently ordered in younger and symptomatic patients.
- General anesthesia was used in all patients with spirometry suggestive of obstruction, without complications. Perioperative complication rate was low (2/37).
Conclusions:
- The routine recommendation for USS before AMM surgery is based on limited evidence.
- USS did not consistently alter anesthetic technique, even when abnormal.
- Low perioperative complication rates suggest that USS may not be critical for all AMM patients; larger studies are needed.