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.
Sachithanandan
Anand
A
Division of Thoracic Surgery, Birmingham Heartlands Hospital, Bordersley Green East, Birmingham B9 5SS, UK. anandsachithanandan@yahoo.com
Ghosh
Shilajit
S
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