Preoperative Evaluation of the High-Risk Surgical Patient for Lung Cancer Resection

Lynn T. Tanoue

doi:10.1055/s-2000-9404

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2000; Volume 21(Number 05): 421-432
DOI: 10.1055/s-2000-9404

Preoperative Evaluation of the High-Risk Surgical Patient for Lung Cancer Resection

Lynn T. Tanoue

Yale University School of Medicine, Pulmonary and Critical Care Section, New Haven, Connecticut

Abstract

ABSTRACT

Surgery is the treatment of choice for patients with stage I or II non-small cell carcinoma of the lung. Many such patients will have concurrent chronic obstructive pulmonary disease, the presence of which may increase the risk of lung resection. Prediction of surgical morbidity and mortality related to impaired pulmonary physiology should be based on evaluation of physiological parameters. Such measurements can be derived from a variety of studies including pulmonary function testing, assessment of split lung function, and measurements of exercise capacity. While there does not exist uniform agreement about threshold levels of risk related to individual tests, judicious use of widely available physiological measurements including FEV1, DL_CO, and V_O2max should enable clinicians to make reasonable assessments of operative risk. Because surgery is clearly optimal treatment for stages I and II non-small cell lung cancer, thoughtful consideration should be given to the decision of operability in each individual case.

KEYWORD

Lung cancer - postoperative complications - pulmonary function tests - exercise testing

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Referenzen

REFERENCES

1 American Cancer Society. Cancer Facts and Figures. 2000.
2 American College of Physicians. Preoperative Pulmonary Function Testing. Ann Int Med . 1990; 112 793-794
3 Gaensler E, Cugell D, Lindgren I, Verstraeten J, Smith S, Strieder J. The role of pulmonary insufficiency in mortality and invalidism following surgery for pulmonary tuberculosis. J Thorac Surg . 1955; 29 163-187
4 Mittman C. Assessment of operative risk in thoracic surgery. Am Rev Respir Dis . 1961; 84 197-207
5 Boushy S, Billig D, North D, Helgason A. Clinical course related to preoperative and postoperative pulmonary function in patients with bronchogenic carcinoma. Chest . 1971; 59 383-391
6 Weiss W, Cooper D, Boncot K. Operative mortality in five year survival rates in men with bronchogenic carcinoma. Ann Int Med . 1969; 71 59-65
7 Wernly J, DeMeester T, Kirchner P, Myerowitz P, Oxford D, Golomb H. Clinical value of quantitative ventilation perfusion lung scans in the surgical management of bronchogenic carcinoma. J Thorac Cardiovasc Surg . 1980; 80 535-543
8 Miller J. Physiologic evaluation of pulmonary function in the candidate for lung resection. J Thorac Cardiovasc Surg . 1993; 105 347-352
9 Nagasaki F, Flehinger B, Martini N. Complications of surgery in the treatment of carcinoma of the lung. Chest . 1982; 82 25-29
10 Olsen G, Block A, Swenson E, Castle J, Wynne J. Pulmonary function evaluation of the lung resection candidate: A prospective study. Am Rev Respir Dis . 1975; 111 379-387
11 Mittman C, Bruderman I. Lung cancer: To operate or not. Am Rev Respir Dis . 1977; 116 477-496
12 Bolliger C, Soler M, Stul P. Evaluation of high-risk lung resection candidates: Pulmonary haemodynamics versus exercise testing. Respiration . 1994; 61 181-186
13 Kearney D, Lee T, Reilly J, DeCamp M, Sugarbaker D. Assessment of operative risk in patients undergoing lung resection. Chest . 1994; 105 753-759
14 Jacobaeus H, Frenckner P, Bjorkman S. Some attempts at determining the volume and function of each lung separately. Acta Med Scand . 1932; 79 174-215
15 Bergan F. A simple method for determinations of the relative functions of the right and left lung. Acta Chir Scan . 1960; 253 S58-S63
16 Carlens E, Hanson H, Nordenstrom B. Temporary unilateral occlusion of the pulmonary artery. J Thorac Surg . 1951; 22 527-536
17 Uggla L. Indications for and results of thoracic surgery with regard to respiratory and circulatory function tests. Acta Clin Scand . 1956; 111 196-212
18 Suzuki C, Arakaki Y, Najorolima Y. Resection tolerance of the patients with lung cancer associated with chronic obstructive pulmonary disease. Sci Rep Res Inst Tohoku Univ . 1970; 17 60-64
19 Taube K, Konietzko N. Prediction of postoperative cardiopulmonary function in patients undergoing pneumonectomy. Thorac Cardiovasc Surg . 1980; 28 348-351
20 Loddenkemper R, Gabler A, Gobel D. Criteria of functional operability in patients with bronchial carcinoma: Preoperative assessment of risk and prediction of postoperative function. Thorac Cardiovasc Surg . 1983; 31 334-336
21 Olsen G, Weiman D, Bolton J. Submaximal invasive exercise testing and quantitative lung scanning in the evaluation for tolerance of lung resection. Chest . 1989; 95 267-273
22 Miorner G. 133xe-radiospirometry. A clinical method for studying regional lung function. Scand J Respir Dis . 1968; S64
23 Kristersson S, Lindell S, Svanberg L. Prediction of pulmonary function loss due to pneumonectomy using 133Xe-radiospirometry. Chest . 1972; 62 694-698
24 Tonnesen K, Dige-Petersen H, Lund J. Lung split function test and pneumonectomy. Scand J Thorac Cardiovas Surg . 1978; 12 133-136
25 Ali M, Mountain C, Ewer M, Johnston D, Haynie T. Predicting loss of pulmonary function after pulmonary resection for bronchogenic carcinoma. Chest . 1980; 77 337-342
26 Ellis D, Hawkins T, Gibson G, Nariman S. Role of lung scanning in assessing the resectability of bronchial carcinoma. Thorax . 1983; 38 261-266
27 Markos J, Mullan B, Hillman D. Preoperative assessment of mortality and morbidity after lung resection. Am Rev Respir Dis . 1989; 139 902-910
28 Corris P, Ellis D, Hawkins T, Gibson G. Use of radionuclide scanning in the preoperative estimation of pulmonary function after pneumonectomy. Thorax . 1987; 42 285-291
29 Gass G, Olsen G. Preoperative pulmonary function testing to predict postoperative morbidity and mortality. Chest . 1986; 89 127-135
30 Segall J, Butterworth B. Ventilatory capacity in chronic bronchitis in relation to carbon dioxide production. Scan J Respir Dis . 1966; 47 215-224
31 Pate P, Tenholder M, Griffin J, Eastridge C, Weiman D. Preoperative assessment of the high-risk patient for lung resection. Ann Thorac Surg . 1996; 61 1494-1500
32 Ferguson M, Little L, Rizzo L. Diffusing capacity predicts morbidity and mortality after pulmonary resection. J Thorac Cardiovasc Surg . 1988; 96 894-900
33 Cander L. Physiologic assessment and management of the preoperative patient with pulmonary emphysema. Am J Cardiol . 1963; 12 324-326
34 Van Nostrand D, Kjelsberg M, Humphrey E. Pre-resectional evaluation of risk from pneumonectomy. Surg Gynecol Obstet . 1968; 127 306-312
35 Holden B, Rice T, Stelmach K, Meker D. Exercise testing, six minute walk and stair climb in the evaluation of patients at high risk of pulmonary resection. Chest . 1992; 102 1774-1779
36 Olsen G, Bolton J, Weiman D, Hornung C. Stair climbing as an exercise test to predict the postoperative complications of lung resection. Chest . 1991; 99 587-590
37 Bolton J, Weiman D, Haynes J, Hornung C, Olsen G, Amand C. Stair climbing as an indicator of pulmonary function. Chest . 1987; 92 783-787
38 Pollock M, Roa J, Benditt J, Celli B. Estimation of ventilatory reserve by stair climbing. A study in patients with chronic air flow obstruction. Chest . 1993; 104 1378-1383
39 Eugene J, Brown S, Light R, Milne N, Stemmer E. Maximum oxygen consumption: A physiologic guide to pulmonary resection. Surg Forum . 1982; 33 260-262
40 Smith T, Kinasewitz G, Tucker W, Spillers W, George R. Exercise capacity as a predictor of post-thoracotomy morbidity. Am Rev Respir Dis . 1984; 129 730-734
41 Bechard D, Wetstein L. Assessment of exercise oxygen consumption as preoperative criterion for lung resection. Ann Thorac Surg . 1987; 44 344-349
42 Epstein S, Saling L, Daly B, Celli B. Predicting complications after pulmonary resection: Preoperative exercise testing versus a multifactorial cardiopulmonary risk index. Chest . 1993; 104 694-700
43 Coleman N, Schraufnagel D, Rivington R, Pardy R. Exercise testing in evaluation of patients for lung resection. Am Rev Respir Dis . 1982; 125 604-606
44 Bolliger C, Jordan P, Soler M. Exercise capacity as predictor of postoperative complications in lung resection candidates. Am J Respir Crit Care Med . 1995; 151 1472-1480
45 Puente-Maestu L, De Lucas P, Amedillo A, Calle M, Tatai E, Monturiol M. Prediction of maximal oxygen uptake after thoracic surgery by radionuclide perfusion scanning. Am Rev Respir Dis . 1994; 149 A785
46 Bolliger C, Wyser C, Roser H, Soler M, Perruchoud A. Lung scanning and exercise testing for the prediction of postoperative performance in lung resection candidates at increased risk for complications. Chest . 1995; 108 341-348
47 Bolliger C, Jordan P, Soler M. Pulmonary function and exercise capacity after lung resection. Eur Respir J . 1996; 9 415-421
48 Nezu K, Kushibe K, Tojo T, Takahama M, Kitamura S. Recovery and limitation of exercise capacity after lung resection for lung cancer. Chest . 1998; 113 1511-1516
49 Morice R, Peters E, Ryan M, Putnam J, Ali M, Roth J. Exercise testing in the evaluation of patients at high risk for complications from lung resection. Chest . 1992; 101 356-361
50 Wyser C, Stulz P, Soler M. Prospective evaluation of an algorithm for the functional assessment of lung resection candidates. Am J Respir Crit Care Med . 1999; 159 1450-1456
51 Brantigan O, Mueller E. Surgical treatment of pulmonary emphysema. Ann Surg . 1957; 23 789-804
52 Cooper J, Trulock E, Triantafillou A. Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg . 1995; 109 106-119
53 Ojo T, Martinez F, Paine R. Lung volume reduction surgery alters management of pulmonary nodules in patients with severe COPD. Chest . 1997; 112 1494-1500
54 McKenna R, Fischel R, Brenner M, Gelb A. Combined operations for lung volume reduction surgery and lung cancer. Chest . 1996; 110 885-888
55 Shields T. Surgical therapy for carcinoma of the lung. Clinics Chest Med . 1993; 14 121-148
56 Bolliger C, Perruchoud A. Functional evaluation of the lung resection candidate. Eur Respir J . 1998; 11 198-212
57 Olsen G. Lung cancer resection: Who's inoperable?. Chest . 1995; 108 298-29