A person being considered for lung resection for cancer should be tested prior to surgery to make sure that the patient can safely tolerate the procedure and loss of lung parenchyma.
Criteria to identify a patient who can safely tolerate surgical lung resection:
(1) PaO2 > 80 mm Hg
(2) oxygen saturation > 90%
(3) pulmonary function tests exceed preoperative targets
(4) pulmonary function tests exceed postoperative targets
If the patient does not meet these criteria, then exercise testing should be done to determine if the patient can tolerate the procedure.
Function Test
Preoperative Value
FEV1
> 60% of predicted
forced vital capacity
> 60% of predicted
diffusing capacity
> 60% of predicted
Function Test
Postoperative Value
FEV1
> 30% of predicted
forced vital capacity
> 30% of predicted
diffusing capacity
> 30% of predicted
where:
• The postoperative value = (100% - (percent reduction)) * (preoperative value)
Extent of Resection
Reduction from Preoperative Value
pneumonectomy
50%
lobe
20%
portion of a lobe (wedge)
(percent of lobe) * 20%
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