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The Annals of Thoracic Surgery, Vol 39, 260-265, Copyright © 1985 by The Society of Thoracic Surgeons
K Nakahara, Y Monden, K Ohno, S Miyoshi, H Maeda and Y Kawashima
We predicted the postoperative forced expiratory volume in 1 second (FEV1)
with a formula based on the premise that the total number of subsegments
was 42: postop FEV1 = [1 - (b - n)/(42 - n)] (preop FEV1), where n and b
are the number of obstructed subsegments and total subsegments,
respectively, in the resected lobe. It was assumed that b was 6, 4, and 12
in the right upper, middle, and lower lobes, respectively, and 10 each in
the left upper and the left lower lobes. The obstructed subsegments, n,
were obtained from the findings on bronchography or bronchofiberscopy or
both before operation. The linear regression line derived from the
correlation between predicted (x) and measured (y) FEV1 was y = 0.850x +
0.286 +/- 0.296 (standard error) (N = 52; r = 0.821; p less than 0.001). We
calculated the predicted postoperative FEV1 in 188 patients with primary
lung cancer. The predicted values were corrected with the regression
equation just mentioned and then normalized by the patient's height and sex
(%FEV1(p,c). The correlation between %FEV1(p,c) and the surgical risk was
studied. Postoperative respiratory complications were inversely related to
%FEV1(p,c), and a significantly high incidence of complications (p less
than 0.05) was observed in those whose %FEV1(p,c) was less than 60% of
predicted normal. In aged patients (65 years old or more) without
complications, %FEV1(p,c) was 67.3 +/- 18.0%; it was 52.2 +/- 12.8% in
those with respiratory trouble and 53.3% +/- 9.6% in those with circulatory
complications. The difference between groups with and without complications
was significant (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
A method for predicting postoperative lung function and its relation to postoperative complications in patients with lung cancer
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