[Evaluation of Functional Operability Prior to Lung Surgery]

Area of Science:

• Cardiology
• Pulmonology
• Thoracic Surgery

Background:

• Pre-lung resection risk stratification necessitates comprehensive cardiac and pulmonary evaluation.
• Identifying and managing pre-existing conditions optimizes surgical candidacy and patient outcomes.

Purpose of the Study:

• To outline the importance of cardiac and pulmonary physiologic assessment before lung resection.
• To detail recommended work-up algorithms for cardiac risk and pulmonary function tests.

Main Methods:

• Utilizes guidelines from ERS/ESTS and ACCP for cardiac risk and pulmonary function testing.
• Includes spirometry, blood gas analysis, diffusion capacity (DLCO), cardiopulmonary exercise testing (CPET), and perfusion scintigraphy.
• Emphasizes clinical assessment of overall patient status and pulmonary function.

Main Results:

• Physiologic assessment uncovers hidden health issues, enabling pre-surgical optimization.
• Facilitates surgeon's estimation of major complication risks and patient's understanding of procedural risks.
• Informed consent or surgical rejection is enabled through clear risk communication.

Conclusions:

• Cardiac and pulmonary assessment are essential for accurate lung resection risk stratification.
• Standardized algorithms and comprehensive testing ensure adequate operative risk assessment.
• Test validity should be critically evaluated, with necessary repetitions to ensure accuracy.