Original articleGeneral thoracicPulmonary Function Tests Do Not Predict Pulmonary Complications After Thoracoscopic Lobectomy
Section snippets
Patients and Methods
After local Institutional Review Board approval was granted, including waiver of the need for patient consent, the Duke University Medical Center Data Center was queried for Current Procedural Terminology codes linked with pulmonary resection by either an open approach or by a thoracoscopic approach between December 1999 and October 2007. Eligibility for this study was restricted to patients who underwent anatomic lobectomy for lung cancer with pulmonary function testing demonstrating either
Results
Lobectomy was performed for lung cancer in 943 patients overall during the study period; 340 of these patients (median age of 67) had either Dlco or FEV1 60% or less (mean % predicted FEV1, 55 ± 1; mean % predicted Dlco, 61 ± 1). Of these 340 patients, 167 patients had lobectomy through thoracotomy and 173 patients through thoracoscopy. Eight patients who underwent an initial attempt at lobectomy through thoracoscopy (4.4% of all patients who underwent attempted thoracoscopic lobectomy)
Comment
Preoperative PFTs are probably the most important tool available to surgeons in evaluating the risk of patients under consideration for major lung resection [3, 4, 5, 6, 7, 8]. The FEV1 and Dlco are the PFT parameters most useful in assessing risk of postoperative morbidity, pulmonary complications, respiratory failure, and death, although there is no general agreement on the individual predictive value of the parameters or the limits beyond which lung resection should not be performed [9, 10,
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