Cardiopulmonary exercise test for risk assessment in lung resection surgery

Rationale: Lung resection is the best treatment for patients with early stage non-small cell lung cancer (NSCLC) and Cardiopulmonary Exercise Test (CPET) has been shown to be a reliable method for stratification of surgical risk. VO2max is the most used variable for this purpose, however gas exchange markers of ventilatory inefficiency might also have a role in predicting outcomes.Objective: To evaluate risk factors for postoperative complications in lung resection for non-small cell lung cancer.Methods: Fifty-five patients (63 ± 11 yrs, 60% male) were prospectively evaluated from 2014 to 2017 for lung resection. They underwent preoperative assessment with spirometry, DLCO and CPET. Twenty-nine patients (53%) were diagnosed with COPD (VEF1 74 ± 20% pred).Results: All patients underwent lung ressection and cardiopulmonary complications rate was 26/55 (47%). Logistic regression analysis showed that DLCO
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research

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The aim of this study was to determine the role of physiological measurements in the evaluation of postoperative risks before lung cancer surgery. Spirometry and ABG were performed for all patients with NSCLC before operation. Diffusion test and CPET were performed to patients with moderate-high risk for operation and the patient who required pneumonectomy. Postoperative complications, mortality and duration of stay in ICU and hospital were recorded.115 NSCLC patients who had limited lung capacity(22F,93M) with a mean age of 62.37±10.11 were included prospectively between Jan2015-Dec2018. 54(46.9%) patients were acc...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Thoracic surgery Source Type: research
Conclusion: COPD group had lower decrease of VO2PEAK and increase the VE/VCO2RCP intercept after surgery.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research
Conclusion: The COPD group had an overestimation of post-operative functional loss.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research
ABSTRACT Objective: Preoperative functional evaluation is central to optimizing the identification of patients with non-small cell lung cancer (NSCLC) who are candidates for surgery. The minute ventilation/carbon dioxide output (VE/VCO2) slope has proven to be a predictor of surgical complications and mortality. Pulmonary rehabilitation programs (PRPs) could influence short-term outcomes in patients with COPD undergoing lung resection. Our objective was to evaluate the effects of a PRP on the VE/VCO2 slope in a cohort of patients with COPD undergoing lung resection for NSCLC. Methods: We retrospectively evaluated 25 consec...
Source: Jornal Brasileiro de Pneumologia - Category: Respiratory Medicine Source Type: research
Conclusion: Pneumonitis after SBRT occur later than after CRT. Although a high percentage of the patients receiving curatively intended radiotherapy developed radiation pneumonitis, this was not reflected in the health related quality of life as measured by CCQ.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung Cancer Source Type: research
Conclusion: These results suggest that advanced lung cancer patients receiving chemotherapy demonstrate benefits from pulmonary rehabilitation including improved physical performance and lung function.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and Chronic Care Source Type: research
This study aimed to compare the prevalence of postoperative pulmonary complications (PPCs) between non-small cell lung cancer (NSCLC) patients in the early stages of chronic obstructive pulmonary disease (COPD) and patients with normal lung function and to assess the role of CAT or SGRQ scores as PPCs risk predictors after lung cancer surgery in patients with early stage COPD.Patients and methods: Patients undergoing pulmonary resection for NSCLC between July 2012 and October 2014 were prospectively enrolled. Preoperative measurements of lung function, dyspnea, and QOL, operative characteristics, PPCs, duration of postoper...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 1.12 Clinical Problems - COPD Source Type: research
Conclusions With careful preoperative selection, surgical resection may safely be offered to lung cancer patients with severe COPD. However, these patients have decreased long-term overall survival. Similar survival between patients with normal lung function and mild to moderate COPD suggests that similar indications for lung cancer operations may be applied.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusion: Surgical treatment is safe in carefully selected patients with severe COPD with respect to postoperative survival. Patients with mild to moderate COPD may be treated like patients without COPD with respect to indications for lung cancer surgery.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 8.1 Thoracic Surgery Source Type: research
Conclusion: The elderly pts with NSCLC may be offered radical surgical treatment in terms of lung function, but they are more prone to develop postoperative complications.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 8.1 Thoracic Surgery Source Type: research
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