Preoperative pulmonary evaluation in patients scheduled for lung operations

Preoperative pulmonary evaluation is essential in order to identify patients at risk for postoperative pulmonary complications (PPCs). Procedure and patient related risk factors should be assessed and modified if possible in order to reduce the incidence of PPCs. The extent of preoperative pulmonary evaluation testing required depends on whether the operation to be performed is thoracic or non-thoracic, in addition with patients' coexisting diseases and risk factors. Lung cancer resection surgery also requires extended preoperative evaluation, which is guided by functional pulmonary testing, including spirometry, diffusing capacity of the lung to carbon monoxide (DLCO) measurement, split function testing, exercise testing and arterial blood gas analysis according to published guidelines. Strategies to reduce the risk of PPCs should always be applied in patients at risk, beginning preoperatively and continuing during intraoperative and postoperative period.