Preoperative Pulmonary Function Testing

PREOPERATIVE pulmonary function testing is easy to perform. Setups for spirometry are cheap and simple, and automated systems are available to compute all varieties of measurement. Today's problems for the clinician are "What does preoperative pulmonary function testing mean?" and "Who needs these studies?" The patient with bronchogenic carcinoma often has concomitant obstructive airway disease, since cigarette smoking is a common factor. If a surgeon contemplates resection of the carcinoma, pneumonectomy looms as a possibility. If the possibility of removing an entire lung exists, the assessment of pulmonary function is mandatory. Consequently, much has been written about preoperative assessment of the pneumonectomy candidate. Assessment for Pneumonectomy The understanding of preoperative assessment for pneumonectomy has proceeded in three phases. First to be recognized was that reduction oftotalfunction made removal of a lung hazardous.1-3The amount of reduction (and by what test) and the hazard of the operation were