Future trends in preoperative evaluation

Thoracic Surgery Clinics
G Varela, N Novoa

Abstract

Preoperative evaluation before lung resection has been frequently addressed in modern medical literature. Actual or predicted pulmonary volumes are considered relevant to predict the risk of surgery. Nevertheless, ppoFEV1 underestimates the real functional loss in the immediate postoperative period when most of the complications occur. Not all patients, however, have comparable functional changes after lobectomy. Minimal impairment or even improvements have been demonstrated in COPD cases after lobectomy. Efforts should be directed to an accurate prediction of the immediate postoperative pulmonary volumes for a better evaluation of high-risk patients caused by respiratory impairment. Future developments are needed on the role of measuring preoperative DLCO and how to evaluate a patient's general cardiorespiratory status. Evidence underlines the relevance of routine evaluation of preoperative DLCO at rest or, better, during exercise for a thorough assessment of patient's capability to adapt to a stressful situation (Fig. 3). Only by improving knowledge about the general condition of the patient, can one assess the physiologic response to surgery. Widespread use of sophisticated or simple exercise tests and measurements or daily ...Continue Reading

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Citations

Dec 15, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Nuria Maria NovoaJacinto Ramos
May 14, 2014·Interactive Cardiovascular and Thoracic Surgery·Ana Rodriguez-LarradJesús Seco
May 28, 2016·Health Research Policy and Systems·Léna D'Ostie-RacineValéry Ridde
Jan 29, 2010·Surgery Today·Siyamek Neragi-MiandoabChristopher Mills

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