Preoperative functional status in patients with lung tuberculosis before pneumonectomy

Abstract

Clinical guideline about functional evaluation of lung cancer patients before lung resection is well known. Patients with lung tuberculosis (LT) have another pathogenesis and morphological changes of lungs. However importance of the functional status in estimating risk of lung resections for patients with LT is not so definitely.

Aim: To evaluate preoperative pulmonary function status in patients with LT who were performed pneumonectomy.

Materials and Methods: Fifty-one patients with LT were studied. Spirometry, bodyplethysmography, diffusion capacity, computed tomography and perfusion scintigraphy were performed before pneumonectomy.

Results. There were obstructive disorders (OD) in 40 patients (FEV₁=65,4% pred., RV=152,7% pred., 95%ДИ 142,0-163,4), restrictive disorders (RD) in 3 patients and mixed disorders (MD) in 5 patients (FEV₁=52,6% pred., 95%CI 43,2,6-62,11; TLC=73,7% pred., 95%ДИ 66,6-80,8) and normal ventilation parameters in 3 patients (FEV₁ from 105,6% to 123,1% pred.). Patients with OD had significant decline of DLCO (DLCO=55,7% pred., 95%CI 52,5-58,9). Patients with RD and MD had severe decline of DLCO (DLCO=40,0%pred., 95%CI 31,8-48,2). Even patients without ventilation disorders had decline of DLCO (from 62,8% to 78,9% pred.). Only 3 patients with OD but all patients with MD had DLCO less 40% pred. There was not registered 30-day postoperative lethality in all group of the surveyed patients.

Conclusions. All patients with LT even without ventilation disorders had decrease of DLCO. Decline of DLCO had been especially expressed in patients with MD. The meaning of DLCO as criterion of functional operability demands the further analysis for patients with LT.