PURPOSE: In a pilot study including a small number of patients, we previously reported reduction of postoperative cardiopulmonary complications by selecting lung tumor resection procedures based on a combination of specific preoperative cardiopulmonary function test results. We sought to confirm these findings in a larger number of patients, while refining cutoff values for the screening tests used to aid in carrying out risk-based selection of resection procedures.
METHODS: In 158 patients requiring lung tumor resection, five preoperative parameters (forced expiratory volume in 1s for the 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 an optimal pulmonary resection procedure. Patients later were grouped according to postoperative course to test the value of this procedure selection method.
RESULTS: Two patients (1.3%) died, one from an acute exacerbation of usual interstitial pneumonia and another from pulmonary embolism. Four patients (2.5%) developed major complications after surgery. Nine patients (5.7%) had mild complications, while 143 (90.5%) had a good postoperative course.
CONCLUSION: Using five preoperative parameters to determine pulmonary resection procedures minimized postoperative deaths and major cardiopulmonary complications.
CLINICAL IMPLICATIONS: This new procedure selection method should limit morbidity and mortality following pulmonary resection.
DISCLOSURE: Yoshinori Nagamatsu, No Financial Disclosure Information; No Product/Research Disclosure Information