Role of Diffusing Capacity in Predicting Complications after Lung Resection for Cancer

Abstract

Background: The purpose of our study was to determine whether the assessment of the diffusing capacity of the lung for carbon monoxide (DL_CO), together with the forced expiratory volume in 1 second (FEV₁), could improve the selection of surgical patients. Methods: The data of 76 patients undergoing major lung resection (pnemonectomy, bilobectomy or lobectomy) for non-small cell lung cancer were retrospectively studied. All patients were reviewed for age, sex, preexisting medical conditions, operative, and pathological findings and postoperative outcome. Results: Univariate and multivariable logistic regression analysis showed that ppoFEV₁ and ppoDL_CO were the only statistically significant predictors of pulmonary complications. In the group of patients with marginal ppoFEV₁ (between 30 - 40 %), ppoDL_CO predicted pulmonary morbidity with a better accuracy (p < 0.005) than ppoFEV₁ (p > 0.05). Multiple regression analysis showed that pneumonectomy was the only statistical factor correlated with mortality (p < 0.05). Conclusion: Our experience seems to suggest that ppoDL_CO is a strong predictor of pulmonary complications after major lung resection, allowing a better surgical selection of the patients with compromised respiratory function.

thoracic surgery - pulmonary function test - carbon monoxide lung diffusion capacity - operative risk - lung cancer

References

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