Preoperative Prediction of Lung Function in Pneumonectomy by Spirometry and Lung Perfusion Scintigraphy

Abstract

Introduction:Nowadays an increasing number of lung resections are being done because of the rising prevalence of lung cancer that occurs mainly in patients with limited lung function, what is caused by common etiologic factor - smoking cigarettes. Loss of lung tissue in such patients can worsen much the postoperative pulmonary function. So it is necessary to asses the postoperative pulmonary function especially after maximal resection, i.e. pneumonectomy.Objective:To check over the accuracy of preoperative prognosis of postoperative lung function after pneumonectomy using spirometry and lung perfusion scinigraphy.Material and methods:The study was done on 17 patients operated at the Clinic for thoracic surgery, who were treated previously at the Clinic for Pulmonary Diseases “Podhrastovi” in the period from 01. 12. 2008. to 01. 06. 2011. Postoperative pulmonary function expressed as ppoFEV1 (predicted postoperative forced expiratory volume in one second) was prognosticated preoperatively using spirometry, i.e.. simple calculation according to the number of the pulmonary segments to be removed and perfusion lung scintigraphy.Results:There is no significant deviation of postoperative achieved values of FEV1 from predicted ones obtained by both methods, and there is no significant differences between predicted values (ppoFEV1) obtained by spirometry and perfusion scintigraphy.Conclusion:It is necessary to asses the postoperative pulmonary function before lung resection to avoid postoperative respiratory failure and other cardiopulmonary complications. It is absolutely necessary for pneumonectomy, i.e.. maximal pulmonary resection. It can be done with great possibility using spirometry or perfusion lung scintigraphy.

Effectiveness of pulmonary rehabilitation and correlations in between functional parameters, extent of thoracic surgery and severity of post-operative complications: randomized clinical trial

“…In clinical practice, observations were made of a relationship between %ppoFEV 1 (% predicted postoperative FEV 1 ) and the development of respiratory insufficiency. It has been stated that amongst patients with %ppoFEV 1 higher than 30% of the predicted FEV 1 , as calculated in respect of sex, weight, height and age, the chance of respiratory insufficiency following resection was very low (8,20). We have observed the same phenomenon during our clinical practice.…”

“…The evidence supporting the use of CPET in pre-operative assessment of the lung cancer surgery patient was examined. CPET methodology and limitations, as well as alternatives to CPET for risk assessment are discussed (6,20,21). In our practice, CPET is an element of the preoperative risk stratification, especially before pneumonectomy and patients with severe comorbidities.…”

Early CT imaging markers of COVID-19 progression

“…Since the right mainstem bronchus is shorter, wider, and more vertical in direction than the left, the anatomical feature may facilitate the invasion of virus, which has been proposed in the cases of influenza pneumonia [23] and H7N9 pneumonia [24]. Besides, the right lower lobe, which included 5 lung segments, seemed to make the largest contribution to ventilation, thus facilitating aspiration of SARS-CoV-2 [25]. The extensive lesions of the right lower lung in the early phase may reflect more viral colonization that leads to further dissemination and progression of the infection.…”

Posterior mediastinal mass compressing the left atrium: A rare complication after lung resection

“…It is known that lung resection leads to a reduction in lung function proportionally to the number of segments resected [1]. Moreover, the symptoms in most of the cases are related to the obvious loss of lung volume leading to inadequate gas exchange.…”