title: Selection of pulmonary resection procedures to reduce postoperative complications in 200 patients.
abstract: OBJECTIVE
  We previously demonstrated in a pilot study that postoperative cardiopulmonary complications could be reduced by selecting pulmonary resection procedures based on the results of a combination of specific preoperative cardiopulmonary function tests. The present study reports a re-examination of the criteria for preoperative screening and prospectively assessed whether the selected surgical procedures were appropriate in 200 patients who underwent the planned extent of pulmonary resection.
  
  
  METHODS
  In 200 patients requiring lung tumor resection, five preoperative parameters (forced expiratory volume in 1 s on the intact side, maximal oxygen uptake, ejection fraction, occluded pulmonary artery pressure, and occluded total pulmonary vascular resistance index) were used to assign each patient to one of five risk categories in order to select the optimal resection procedure. Thereafter, the postoperative course was investigated to determine the value of this selection method.
  
  
  RESULTS
  Thoracotomy was performed in 195 of the 200 patients (97.5%). Two patients (1%) died; one patient succumbed to acute exacerbation of interstitial pneumonia and the other patient died from pulmonary embolism. Six patients (3.1%) developed major complications after surgery and 12 patients (6.2%) had mild complications, while 175 (89.7%) showed a good postoperative course.
  
  
  CONCLUSIONS
  The use of five preoperative parameters to select the pulmonary resection procedure minimized postoperative death and major complications.
authors.affiliation: Department of Surgery, National Hospital Organization Omuta National Hospital, 1044-1 Tachibana, Omuta, Fukuoka, 837-0911, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nagamatsu
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Masaki
authors.initials: M
authors.lastname: Kashihara
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishi
authors.forename: Koichi
authors.initials: K
authors.lastname: Yoshiyama
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamana
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shirouzu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012129:Respiratory Function Tests; D018570:Risk Assessment