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Related Experiment Videos

Prospective evaluation for pneumonectomy using the 99mtechnetium quantitative perfusion lung scan

P G Boysen, A J Block, G N Olsen

    Chest
    |October 1, 1977
    PubMed
    Summary

    For patients undergoing pneumonectomy, a predicted postoperative forced expiratory volume in one second (FEV1) over 800 ml indicates physiological clearance for surgery. This simple criterion helps determine surgical candidacy and manage perioperative risk in high-risk individuals.

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    Area of Science:

    • Pulmonary Medicine
    • Thoracic Surgery
    • Cardiopulmonary Physiology

    Background:

    • Pneumonectomy is a high-risk surgery for patients with compromised lung function.
    • Accurate physiological assessment is crucial for determining surgical candidacy and minimizing perioperative mortality.

    Purpose of the Study:

    • To evaluate the efficacy of predicted postoperative forced expiratory volume in one second (ppFEV1) derived from quantitative perfusion lung scans in clearing high-risk patients for pneumonectomy.
    • To establish simple physiological criteria for determining pneumonectomy tolerance.

    Main Methods:

    • Quantitative perfusion lung scans were used to assess lung perfusion distribution in 33 high-risk patients.
    • Predicted postoperative FEV1 was calculated using preoperative FEV1 and lung scan data.

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  • Patients with a ppFEV1 exceeding 800 ml were deemed physiologically cleared for pneumonectomy.

    • Main Results:

    • The study included 33 high-risk patients with preoperative FEV1 < 2.0 L.
    • A predicted postoperative FEV1 > 800 ml was used as the criterion for surgical clearance.
    • The perioperative mortality rate was 15% (5/33), considered acceptable for this magnitude of surgery.

    Conclusions:

    • Simple physiological criteria, specifically a predicted postoperative FEV1 > 800 ml, are effective in clearing high-risk patients for pneumonectomy.
    • This approach aids in managing perioperative risk and determining surgical tolerance in patients undergoing major lung resection.