Tuberc Respir Dis.  2000 Jan;48(1):14-23.

Preoperative Evaluation for the Prediction of Postoperative Mortality and Morbidity in Lung Cancer Candidates with Impaired Lung Function

Affiliations
  • 1Department of Internal Medicine, Gachon Medical School, Gil Medical Center, Korea.
  • 2Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND: The evaluation of candidates for successful lung resection is important. We studied to Our study was conducted to determine the preoperative predictors of postoperative mortality and morbidity in lung cancer patients with impaired lung function. METHOD: Between October 1, 1995 to August 31, 1997, 36 lung resection candidates with FEV1 of less than 2L or 60% predicted due to lung cancer were included prospectively. Age, sex, weight loss, hematocrit, serum albumin, EKG and concomitant illness were considered as systemic potential predictors for a successful lung resection. Smoking history, presence of pneumonia, dyspnea scale(1 to 4), arterial blood gas analysis with room air breathing, routine pulmonary function test were also included for the analysis. In addition, predicted postoperative(ppo)pulmonary factors such as ppo-FEV1, ppo-diffusing capacity(DLco), predicted postoperative product(PPP) of ppo-FEV1% x ppo-DLco% and ppo-maximal O2 uptake(VO2max) were also measured.
RESULTS
There were 31 men and 5 women with the median age of 65 years (range 44 to 82) and a mean FEV1 of 1.78 +/-0.06L. Pneumonectomy was performed in 14 patients, bilobectomy in 8, lobectomy in 14. Pulmonary complications developed in 10 patients, cardiac complications in 3, other complications (empyema, air leak, bleeding) in 4. Twelve patients were managed in the intensive care unit for more than 48 hours. Two patients died within 30 days after operation. The ppo-VO2max was less than 10 mg/kg/min in these two patients. MVV was the only predictor for the pulmonary complications. However, there was no predictors for the post operative death in this study.


MeSH Terms

Blood Gas Analysis
Dyspnea
Electrocardiography
Female
Hematocrit
Humans
Intensive Care Units
Lung Neoplasms*
Lung*
Male
Mortality*
Pneumonectomy
Pneumonia
Prospective Studies
Respiration
Respiratory Function Tests
Serum Albumin
Smoke
Smoking
Weight Loss
Serum Albumin
Smoke
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