[Lung resection surgery in patients with functional limits]

To determine whether there exists in our area concordance between forced expiratory volume in one second (FEV1) estimated before surgery by ventilation/perfusion scintigraphy and real values after surgery in patients undergoing pneumonectomy and lobectomy. Prospective descriptive study. We studied 15 patients undergoing pneumonectomy (M/F 14:1, age 62 +/- 7.5 years) and 11 undergoing lobectomy (M/F 11:0 age 66 +/- 3.5 years) in the thoracic surgery unit of Hospital de Cruces between 1 March 1990 and 1 March 1993. The FEV1 of all patients before surgery was under 2.1 liters. Tumors were malignant in 23 patients and benign in 3. Ventilation/perfusion gammagrams were obtained for all patients before surgery in order to predict the loss of function after resection of the parenchyma. Two months after surgery spirometric testing was done. The FEV1 calculated based on the results of scintigraphy was compared to the real FEV1 after resection by way of graphic concordance and by calculation of a within-group correlation coefficient. A correlation coefficient of 0.82 (p < 0.001) was obtained for FEV1 estimated by ventilation and real FEV1 in patients who underwent pneumonectomy, indicating good concordance. The correlation coefficient was 0.59 (p < 0.001) indicating moderate agreement between FEV1 estimated by perfusion and real FEV1 after resection. Correlation was statistically insignificant in lobectomy patients (0.28 by the method of Ali and 0.35 by Wernly's; p = 0.19 and 0.13, respectively). Ventilation scintigraphy offers an acceptably reliable prediction of FEV1 after lung resection. The reliability of measurements estimated by scintigraphy in lobectomized patients is not acceptable.