[Prediction of performance status after pneumonectomy].
To predict performance status (P.S.) following pneumonectomy, patients with lung carcinoma underwent pre-surgical pulmonary function tests with spirometry and unilateral pulmonary artery occlusion test (UPAO test). Between 1980 and 1991, twenty-nine patients who had survived more than six months after surgery were selected for the study. These patients were divided into two groups according to P.S. measured at six months after surgery: 16 patients with P.S. 0 to 1 were in Group A, and 13 patients with P.S. 2 to 3 were in Group B. The results of the following tests obtained prior to surgery were compared for the two groups to predict post-surgical P.S.; vital capacity (VC), VC/m2, forced expiratory volume in 1 second (FEV1.0), FEV1.0/m2, predicted VC/m2 and predicted FEV1.0/m2 calculated with residual pulmonary segments, mean pulmonary arterial pressure (PPA) before UPAO and 15 minutes after UPAO, total pulmonary vascular resistance (TPVR) before and during UPAO, and rate of changes in PPA and TPVR. Results obtained were as follows: Group B demonstrated significantly higher TPVR (p < 0.05) before the UPAO, PPA (p < 0.05) and TPVR (p < 0.002) during UPAO, and rate of change in TPVR (p < 0.02) than those in Group A. There were no significant differences between the two groups for other test results. From these results, lowering of post-surgical P.S. might be predicted when the TPVR during UPAO was 350 dyne.sec.cm-5/m2 or more.
First Department of Surgery, Kurume University School of Medicine, Japan.
Y
Y
Nagamatsu
H
H
Ono
M
M
Tsushimi
K
K
Takagi
D
D
Iwanaga
K
K
Nasu
A
A
Hayashi
A
A
Adachi
R
R
Hayashida
T
T
Kakegawa
D001794:Blood Pressure; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000601:surgery; D011013:Pneumonectomy; D011379:Prognosis; D012129:Respiratory Function Tests; D013147:Spirometry; D014655:Vascular Resistance