Temporary main bronchial occlusion under bronchoscopic control in the evaluation of candidates for pneumonectomy.
BACKGROUND
In this study we report our experience with temporary main bronchial occlusion in the preoperative evaluation of candidates for pneumonectomy.


METHODS
Between January 1991 and January 1994, 57 candidates for pneumonectomy underwent a 15-minute temporary main bronchial occlusion with an inflatable balloon during fiberoptic bronchoscopy. The following parameters were monitored during bronchial occlusion: general status, ECG, arterial pressure, heart rate and respiratory rate. Arterial blood gases were measured after 7 and 14 minutes. Values at 7 and at 14 minutes were compared with those obtained before the procedure. Patients were considered suitable surgical candidates for pneumonectomy if PaCO2 < 42 mmHg and pH > 7.35.


RESULTS
Fifty-three patients were considered functionally operable. Three patients were considered functionally inoperable (PaCO2 > 42 mmHg, pH < 7.35 and appearance of dyspnea). One patient was excluded from the analysis because of balloon mispositioning due to a coughing fit. Sixteen of the operable patients underwent pneumonectomy and all did well without clinical evidence of respiratory insufficiency. At present 11 patients are alive, all without chronic respiratory insufficiency (mean follow-up 14 months). No postoperative mortality related to cardiorespiratory problems was observed.


CONCLUSIONS
Temporary main bronchial occlusion is a simple and inexpensive test that can correctly predict functional resectability in candidates for pneumonectomy.
Melloni
G
G
Institute for Cardiovascular and Respiratory Disease, University of Milan Scientific Institute San Raffaele Hospital, Italy.
Zannini
P
P
Carretta
A
A
Chiesa
G
G
Grossi
A
A
D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D001999:Bronchoscopy / Q000191:economics / Q000379:methods*; D002404:Catheterization; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011300:Preoperative Care; D012129:Respiratory Function Tests / Q000191:economics / Q000379:methods*