Clinical Course Related to Preoperative and Postoperative Pulmonary Function in Patients with Bronchogenic Carcinoma

Unrotated factor analysis comparing patients who did well after operation with those who did not tolerate surgery due to respiratory causes revealed the FEV1 to be the most helpful in separating these two groups. Several other function tests also separated these two groups. Decrease in FEV1 after lung resection was inversely related to the degree of airway obstruction. The more normal patients had greater decrease in FEV1 and were more likely to experience decrease in exercise tolerance as compared to the more obstructed patients. The frequency of patients with worsening dyspnea after pneumonectomy and lobectomy was similar. Changes in exercise tolerance after resection were not related to morphologic emphysema nor bronchitis in the remaining lung as judged from examination of the resected specimen. Patients with postoperative atelectasis had higher lung volumes and compliance as compared to those without atelectasis. Chest roentgenograms of 12 pneumonectomy patients 3 and 30 months after operation showed “hyperinflation” in six. Lung volume measurements, however, showed no change.