The value of a preoperative ventilation-perfusion scan in patient selection for pneumonectomy.
Guidelines regarding operability of patients with lung cancer are well established. The measured and predicted pulmonary function provides a practical guide to the safety of lobectomy or pneumonectomy. We describe a patient who had an unexplained precipitous fall in preoperative FEV(1) that would have precluded a required pneumonectomy but for an urgent ventilation-perfusion (V/Q) scan. This case highlights the fact that clinical acumen rather than a strict adherence to established guidelines is vital in the assessment of lung cancer patients awaiting potentially curative surgery.
Division of Thoracic Surgery, Birmingham Heartlands Hospital, Bordersley Green East, Birmingham B9 5SS, UK. anandsachithanandan@yahoo.com
Anand
A
Sachithanandan
Shilajit
S
Ghosh
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology* / Q000601:surgery; D005541:Forced Expiratory Volume; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D018579:Patient Selection; D011013:Pneumonectomy; D014692:Ventilation-Perfusion Ratio; D014797:Vital Capacity