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Ann Thorac Surg 1996;62:974-975
© 1996 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 968.

DR MARK K. FERGUSON (Chicago, IL): I congratulate Drs Bousamra and Haasler on a very interesting paper. This represents one of the first prospective studies and is a necessary follow-up to the original reports that DLCO is an independent factor associated with the risk of morbidity and mortality in patients undergoing major lung resection.

Their most important finding in this contemporary series of patients was that DLCO correlates with morbidity, particularly pulmonary morbidity. These data reinforce the utility of assessing DLCO in estimating the risk of major lung resection.

They did not confirm that DLCO is correlated with mortality. Their mortality rate in both the low- and high-DLCO groups was quite acceptable, and it is likely that the equivalent rates were due in large part to improved postoperative care, including pain control and aggressive pulmonary toilet. However, I wonder whether the good outcomes in this study were due perhaps to spuriously low DLCO measurements in some of their patients. You mentioned that your DLCO values were corrected for anemia, and I presume that you mean corrected for hemoglobin, on all of the patients. I wonder whether they were also volume adjusted, which generally increases the DLCO value and might have put many of your patients into a low-risk category. I also note that the values of forced expiratory volume in 1 second were relatively high in both of your groups, and I would like you to reflect on whether you think this might have affected the outcome in your patients.

I think the most important original finding in your report is that with long-term follow-up, there was relative pulmonary insufficiency in a large number of patients in the . . . [Full Text of this Article]


Related Article

Early and Late Morbidity in Patients Undergoing Pulmonary Resection With Low Diffusion Capacity
Michael Bousamra, II, Kenneth W. Presberg, Joseph H. Chammas, James S. Tweddell, Barry L. Winton, Mark R. Bielefeld, and George B. Haasler
Ann. Thorac. Surg. 1996 62: 968-974. [Abstract] [Full Text]





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Copyright © 1996 by The Society of Thoracic Surgeons.