Selection of pulmonary resection procedures to avoid postoperative complications.
OBJECTIVE
We previously found a potential predictive value in a retrospective analysis of spirometry and an expired gas analysis during the exercise. We sought to reduce postoperative cardiopulmonary complications by selecting lung tumor resection procedures based on a combination of specific preoperative cardiopulmonary function test results.


METHODS
Out of the 53 patients requiring a lung tumor resection, five preoperative parameters (forced expiratory volume in 1 s for intact-side, maximal oxygen uptake, ejection fraction, occluded pulmonary artery pressure, and occluded total pulmonary vascular resistant index) were used to assign patients to one of five risk categories in order to select the optimal pulmonary resection procedure. The patients were later grouped according to their postoperative course to test the value of this procedure selection method.


RESULTS
No patient died or developed severe complications after surgery. Five patients had mild complications, while 46 had a good postoperative course; the 13 deaths, in the cancer cases, included 11 from primary or metastatic cancer and 2 from other causes. The overall five-year survival was 61.4%.


CONCLUSIONS
This method for determining a pulmonary resection procedure avoided postoperative deaths and severe cardiopulmonary complications, while achieving a good outcome.
Nagamatsu
Yoshinori
Y
Department of Surgery, National Hospital Organization, Omuta National Hospital, 1044-1 Tachibana, Ohmuta, Fukuoka 837-0911, Japan.
Maeshiro
Kanetaka
K
Kashihara
Masaki
M
Iwasaki
Yasunori
Y
Shima
Ichirou
I
Yamana
Hideaki
H
Shirouzu
Kazuo
K
D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D005080:Exercise Test; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000517:prevention & control*; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests; D013147:Spirometry