Role of diffusing capacity in predicting complications after lung resection for cancer.
BACKGROUND
The purpose of our study was to determine whether the assessment of the diffusing capacity of the lung for carbon monoxide (DL (CO)), together with the forced expiratory volume in 1 second (FEV (1)), could improve the selection of surgical patients.


METHODS
The data of 76 patients undergoing major lung resection (pnemonectomy, bilobectomy or lobectomy) for non-small cell lung cancer were retrospectively studied. All patients were reviewed for age, sex, preexisting medical conditions, operative, and pathological findings and postoperative outcome.


RESULTS
Univariate and multivariable logistic regression analysis showed that ppoFEV (1) and ppoDL (CO) were the only statistically significant predictors of pulmonary complications. In the group of patients with marginal ppoFEV (1) (between 30 - 40 %), ppoDL (CO) predicted pulmonary morbidity with a better accuracy ( P < 0.005) than ppoFEV (1) ( P > 0.05). Multiple regression analysis showed that pneumonectomy was the only statistical factor correlated with mortality ( P < 0.05).


CONCLUSIONS
Our experience seems to suggest that ppoDL (CO) is a strong predictor of pulmonary complications after major lung resection, allowing a better surgical selection of the patients with compromised respiratory function.
Santini
M
M
Department of Thoracic Surgery Unit, Second University of Naples, Naples, Italy. mario.santini@unina2.it
Fiorello
A
A
Vicidomini
G
G
Di Crescenzo
V G
VG
Laperuta
P
P
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000503:physiopathology*; D011379:Prognosis; D011653:Pulmonary Diffusing Capacity / Q000502:physiology*; D012189:Retrospective Studies