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The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 347-351, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JI Miller Jr
From July 1, 1974, to December 31, 1990, 2340 patients who underwent
pulmonary resection were evaluated by comprehensive analysis of pulmonary
function. Pulmonary function test criteria for resection were (1)
pneumonectomy: forced expiratory volume in 1 second greater than 2 L;
forced expiratory flow rate from 25% to 75% greater than 1.6 L; maximum
voluntary ventilation greater than 55%; (2) lobectomy: forced expiratory
volume in 1 second greater than 1 L; forced expiratory flow rate from 25%
to 75% greater than 0.6 L; maximum voluntary ventilation greater than 40%;
(3) wedge or segmental resection: forced expiratory volume in 1 second
greater than 0.6 L; forced expiratory flow rate from 25% to 75% greater
than 0.6 L; maximum voluntary ventilation greater than 35%. Split perfusion
lung scan and Reichel exercise stress testing were utilized as indicated.
When these values of pulmonary function have been applied, a more precise
method of selecting patients for various types of pulmonary resection has
resulted in a lower mortality while denying operation to less than 1% of
the patients who are considered for surgical resection.
ARTICLES
Physiologic evaluation of pulmonary function in the candidate for lung resection
Emory University School of Medicine, Emory Clinic, Atlanta, GA 30308.
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