Progress in application of preoperative cardiopulmonary reserve assessment in patients with lung resection surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SU Mengdan ,  WEI Wei

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

WEI Wei, Email: 111weiwei@sohu.com

Keywords：

Cardiopulmonary reserve function; thoracic surgery; preoperative risk assessment; review

DOI：

10.7507/1007-4848.202010069

Video：

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Surgical operation is the first choice for most patients who suffer from early non-small cell lung cancer. The risk of ordinary thoracic surgery is between intermediate and high risk. Due to the high incidence of postoperative pulmonary complications after thoracic surgery, preoperative cardiopulmonary reserve assessment is extremely necessary and important. In recent years, lots of assessment tools are clinically used, including pulmonary function tests, arterial blood gas analysis, breath-holding test and 6-minute walk test. In addition, cardiopulmonary exercise test is used extensively. This article reviews the current status of preoperative cardiopulmonary reserve assessment in thoracic surgery to guide clinical decisions, reduce postoperative complications and improve outcomes.

Citation： SU Mengdan, WEI Wei. Progress in application of preoperative cardiopulmonary reserve assessment in patients with lung resection surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1125-1129. doi: 10.7507/1007-4848.202010069 Copy

1.	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2.	Yang X, Wang S, Qu J. Video-assisted thoracic surgery (VATS) compares favorably with thoracotomy for the treatment of lung cancer: A five-year outcome comparison. World J Surg, 2009, 33(9): 1857-1861.
3.	Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: Epidemiology, etiology, and prevention. Clin Chest Med, 2011, 32(4): 605-644.
4.	Kutlu CA, Williams EA, Evans TW, et al. Acute lung injury and acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg, 2000, 69(2): 376-380.
5.	Miller JI. Physiologic evaluation of pulmonary function in the candidate for lung resection. J Thorac Cardiovasc Surg, 1993, 105(2): 347-351.
6.	Beckles MA, Spiro SG, Colice GL, et al. The physiologic evaluation of patients with lung cancer being considered for resectional surgery. Chest, 2003, 123(1 Suppl): 105S-114S.
7.	Yoshimi K, Oh S, Suzuki K, et al. Impact of airflow limitation on comorbidities and postoperative complications in patients undergoing thoracic surgery: A retrospective observational study. Ann Thorac Cardiovasc Surg, 2016, 22(3): 146-152.
8.	Keddissi JI, Kinasewitz GT. The more, the better: Maximum oxygen uptake and lung resection. Chest, 2005, 127(4): 1092-1094.
9.	Ferguson MK, Vigneswaran WT. Diffusing capacity predicts morbidity after lung resection in patients without obstructive lung disease. Ann Thorac Surg, 2008, 85(4): 1158-1164.
10.	Markos J, Mullan BP, Hillman DR, et al. Preoperative assessment as a predictor of mortality and morbidity after lung resection. Am Rev Respir Dis, 1989, 139(4): 902-910.
11.	Sawabata N, Nagayasu T, Kadota Y, et al. Risk assessment of lung resection for lung cancer according to pulmonary function: Republication of systematic review and proposals by guideline committee of the Japanese Association for Chest Surgery 2014. Gen Thorac Cardiovasc Surg, 2015, 63(1): 14-21.
12.	de Torres JP, Marín JM, Casanova C, et al. Lung cancer in patients with chronic obstructive pulmonary disease—Incidence and predicting factors. Am J Respir Crit Care Med, 2011, 184(8): 913-919.
13.	McAlister FA, Khan NA, Straus SE, et al. Accuracy of the preoperative assessment in predicting pulmonary risk after nonthoracic surgery. Am J Respir Crit Care Med, 2003, 167(5): 741-744.
14.	Campos JH, Feider A. Hypoxia during one-lung ventilation—A review and update. J Cardiothorac Vasc Anesth, 2018, 32(5): 2330-2338.
15.	Gould G, Pearce A. Assessment of suitability for lung resection. Contin Educ Anaesth Crit Care Pain, 2006, 6(3): 97-100.
16.	Fernandes EO, Teixeira C, Silva LC. Thoracic surgery: Risk factors for postoperative complications of lung resection. Rev Assoc Med Bras (1992), 2011, 57(3): 292-298.
17.	Mizuguchi, Shinjiro, Takashi I, et al. Arterial blood gases predict long-term prognosis in stageⅠ non-small cell lung cancer patients. BMC Surgery, 2016, 16(3): 3.
18.	徐城, 崔珊珊, 夏中元. 纤维支气管镜使用后单肺手术期间低氧血症的多因素分析. 分子影像学杂志, 2020, 43(3): 516-519.
19.	Beaumont M, Losq A, Péran L, et al. Comparison of 3-minute step test (3MStepT) and 6-minute walk test (6MWT) in patients with COPD. COPD, 2019, 16(3-4): 266-271.
20.	Brunelli A, Kim AW, Berger KI, et al. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e166S-e190S.
21.	殷欣, 许智博, 钱福勇, 等. 公式计算的心肺适能(CRF)和6分钟步行距离(6MWD)预测上腹部大手术术后肺部并发症(PPCs)的效能比较. 复旦学报(医学版), 2020, 47(3): 320-326.
22.	Marjanski T, Wnuk D, Bosakowski D, et al. Patients who do not reach a distance of 500 m during the 6-min walk test have an increased risk of postoperative complications and prolonged hospital stay after lobectomy. Eur J Cardiothorac Surg, 2015, 47(5): e213-e219.
23.	Agarwala P, Salzman SH. Six-minute walk test: Clinical role, technique, coding, and reimbursement. Chest, 2020, 157(3): 603-611.
24.	Balady GJ, Arena R, Sietsema K, et al. Clinician's guide to cardiopulmonary exercise testing in adults: A scientific statement from the American Heart Association. Circulation, 2010, 122(2): 191-225.
25.	姜格宁, 张雷, 朱余明, 等. 肺切除手术患者术前肺功能评估肺科共识. 中国胸心血管外科临床杂志, 2020, 27(1): 1-9.
26.	Brunelli A, Belardinelli R, Refai M, et al. Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in candidates to major lung resection. Chest, 2009, 135(5): 1260-1267.
27.	Oga T, Nishimura K, Tsukino M, et al. Analysis of the factors related to mortality in chronic obstructive pulmonary disease: Role of exercise capacity and health status. Am J Respir Crit Care Med, 2003, 167(4): 544-549.
28.	Baba R, Nagashima M, Goto M, et al. Oxygen uptake efficiency slope: A new index of cardiorespiratory functional reserve derived from the relation between oxygen uptake and minute ventilation during incremental exercise. J Am Coll Cardiol, 1996, 28(6): 1567-1572.
29.	王俊义, 张鹏, 刘毅梅, 等. 6分钟步行试验与运动心肺功能测定预测肺癌患者术后并发症的价值. 天津医科大学学报, 2013, 19(2): 137-139.
30.	Ninan M, Sommers KE, Landreneau RJ, et al. Standardized exercise oximetry predicts postpneumonectomy outcome. Ann Thorac Surg, 1997, 64(2): 328-332.

1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
2. Yang X, Wang S, Qu J. Video-assisted thoracic surgery (VATS) compares favorably with thoracotomy for the treatment of lung cancer: A five-year outcome comparison. World J Surg, 2009, 33(9): 1857-1861.
3. Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: Epidemiology, etiology, and prevention. Clin Chest Med, 2011, 32(4): 605-644.
4. Kutlu CA, Williams EA, Evans TW, et al. Acute lung injury and acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg, 2000, 69(2): 376-380.
5. Miller JI. Physiologic evaluation of pulmonary function in the candidate for lung resection. J Thorac Cardiovasc Surg, 1993, 105(2): 347-351.
6. Beckles MA, Spiro SG, Colice GL, et al. The physiologic evaluation of patients with lung cancer being considered for resectional surgery. Chest, 2003, 123(1 Suppl): 105S-114S.
7. Yoshimi K, Oh S, Suzuki K, et al. Impact of airflow limitation on comorbidities and postoperative complications in patients undergoing thoracic surgery: A retrospective observational study. Ann Thorac Cardiovasc Surg, 2016, 22(3): 146-152.
8. Keddissi JI, Kinasewitz GT. The more, the better: Maximum oxygen uptake and lung resection. Chest, 2005, 127(4): 1092-1094.
9. Ferguson MK, Vigneswaran WT. Diffusing capacity predicts morbidity after lung resection in patients without obstructive lung disease. Ann Thorac Surg, 2008, 85(4): 1158-1164.
10. Markos J, Mullan BP, Hillman DR, et al. Preoperative assessment as a predictor of mortality and morbidity after lung resection. Am Rev Respir Dis, 1989, 139(4): 902-910.
11. Sawabata N, Nagayasu T, Kadota Y, et al. Risk assessment of lung resection for lung cancer according to pulmonary function: Republication of systematic review and proposals by guideline committee of the Japanese Association for Chest Surgery 2014. Gen Thorac Cardiovasc Surg, 2015, 63(1): 14-21.
12. de Torres JP, Marín JM, Casanova C, et al. Lung cancer in patients with chronic obstructive pulmonary disease—Incidence and predicting factors. Am J Respir Crit Care Med, 2011, 184(8): 913-919.
13. McAlister FA, Khan NA, Straus SE, et al. Accuracy of the preoperative assessment in predicting pulmonary risk after nonthoracic surgery. Am J Respir Crit Care Med, 2003, 167(5): 741-744.
14. Campos JH, Feider A. Hypoxia during one-lung ventilation—A review and update. J Cardiothorac Vasc Anesth, 2018, 32(5): 2330-2338.
15. Gould G, Pearce A. Assessment of suitability for lung resection. Contin Educ Anaesth Crit Care Pain, 2006, 6(3): 97-100.
16. Fernandes EO, Teixeira C, Silva LC. Thoracic surgery: Risk factors for postoperative complications of lung resection. Rev Assoc Med Bras (1992), 2011, 57(3): 292-298.
17. Mizuguchi, Shinjiro, Takashi I, et al. Arterial blood gases predict long-term prognosis in stageⅠ non-small cell lung cancer patients. BMC Surgery, 2016, 16(3): 3.
18. 徐城, 崔珊珊, 夏中元. 纤维支气管镜使用后单肺手术期间低氧血症的多因素分析. 分子影像学杂志, 2020, 43(3): 516-519.
19. Beaumont M, Losq A, Péran L, et al. Comparison of 3-minute step test (3MStepT) and 6-minute walk test (6MWT) in patients with COPD. COPD, 2019, 16(3-4): 266-271.
20. Brunelli A, Kim AW, Berger KI, et al. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e166S-e190S.
21. 殷欣, 许智博, 钱福勇, 等. 公式计算的心肺适能(CRF)和6分钟步行距离(6MWD)预测上腹部大手术术后肺部并发症(PPCs)的效能比较. 复旦学报(医学版), 2020, 47(3): 320-326.
22. Marjanski T, Wnuk D, Bosakowski D, et al. Patients who do not reach a distance of 500 m during the 6-min walk test have an increased risk of postoperative complications and prolonged hospital stay after lobectomy. Eur J Cardiothorac Surg, 2015, 47(5): e213-e219.
23. Agarwala P, Salzman SH. Six-minute walk test: Clinical role, technique, coding, and reimbursement. Chest, 2020, 157(3): 603-611.
24. Balady GJ, Arena R, Sietsema K, et al. Clinician's guide to cardiopulmonary exercise testing in adults: A scientific statement from the American Heart Association. Circulation, 2010, 122(2): 191-225.
25. 姜格宁, 张雷, 朱余明, 等. 肺切除手术患者术前肺功能评估肺科共识. 中国胸心血管外科临床杂志, 2020, 27(1): 1-9.
26. Brunelli A, Belardinelli R, Refai M, et al. Peak oxygen consumption during cardiopulmonary exercise test improves risk stratification in candidates to major lung resection. Chest, 2009, 135(5): 1260-1267.
27. Oga T, Nishimura K, Tsukino M, et al. Analysis of the factors related to mortality in chronic obstructive pulmonary disease: Role of exercise capacity and health status. Am J Respir Crit Care Med, 2003, 167(4): 544-549.
28. Baba R, Nagashima M, Goto M, et al. Oxygen uptake efficiency slope: A new index of cardiorespiratory functional reserve derived from the relation between oxygen uptake and minute ventilation during incremental exercise. J Am Coll Cardiol, 1996, 28(6): 1567-1572.
29. 王俊义, 张鹏, 刘毅梅, 等. 6分钟步行试验与运动心肺功能测定预测肺癌患者术后并发症的价值. 天津医科大学学报, 2013, 19(2): 137-139.
30. Ninan M, Sommers KE, Landreneau RJ, et al. Standardized exercise oximetry predicts postpneumonectomy outcome. Ann Thorac Surg, 1997, 64(2): 328-332.

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Progress in application of preoperative cardiopulmonary reserve assessment in patients with lung resection surgery

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