Preoperative evaluation of lung cancer: predicting the impact of surgery on physiology and quality of life
Preoperative evaluation of lung cancer: predicting the impact of surgery on physiology and quality of life
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DOI：
10.1097/mcp.0b013e328300caac
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发表时间：
2008-07-01
影响因子：
3.3
通讯作者：
Salati, Michele
中科院分区：
文献类型：
--
作者：
Brunelli, Alessandro;Salati, Michele
综述目的总结近一年来发表的关于肺癌患者肺切除术后功能评价和剩余生活质量的最佳临床证据。最近的发现最近的证据表明，预测术后1 s的用力呼气量并不能可靠地预测阻塞性肺疾病患者的并发症，一氧化碳肺弥散量甚至可以预测1 s的正常用力呼气量患者的并发症。与传统的裂肺功能测量相比，最大爬楼梯试验似乎能更好地区分复杂和非复杂患者。无法攀爬12米的患者的并发症和死亡率是能够攀爬22米的患者的2.5倍和13倍。大多数肺切除术后患者的生活质量在第一个月下降，但在3个月后恢复到术前水平。一氧化碳肺弥散能力和爬楼梯试验应在所有肺切除患者中常规进行。在爬楼梯试验或运动氧饱和度测试中运动耐受性差的患者，或肺切除术患者，建议测量VO2max。生活质量应该始终通过特定的工具来评估，而不是通过传统的功能测试来推断。
Purpose of reviewTo summarize the best clinical evidence published in the last year and regarding the functional evaluation and the residual quality of life after lung resection in patients with lung cancer.Recent findingsRecent evidences have shown that predicted postoperative forced expiratory volume in 1 s is not a reliable predictor of complications in patients with obstructive pulmonary disease and that carbon monoxide lung diffusion capacity predicts complications even in patients with normal forced expiratory volume in 1 s. Maximal stair-climbing test appears to discriminate better between complicated and noncomplicated patients compared with traditional split-lung function measures. Patients unable to climb 12 m have 2.5-fold and 13-fold higher complications and mortality rates compared with those able to climb 22 m.Quality of life has been shown to decrease in the first month but to return to preoperative values after 3 months in most of the patients after lung resection.SummaryCarbon monoxide lung diffusion capacity and stair-climbing test should be performed routinely in all lung-resection candidates. In those with poor exercise tolerance in stair-climbing test or exercise oxygen desaturation, or candidates to pneumonectomy, the measurement of VO2max is recommended. Quality of life should always be assessed through specific instruments and not inferred by traditional functional tests.