PREDICTION OF POSTOPERATIVE CARDIOPULMONARY FUNCTION USING PERFUSION SCINTIGRAPHY IN PATIENTS WITH BRONCHOGENIC-CARCINOMA

Both ventilation and perfusion scintigraphy are accurate predictors of postoperative ventilatory function. Previous attempts to predict post -operative exercise capacity after lung resection using radioisotope s cintigraphy are few and results are conflicting. We studied 32 patient s before and 6 months after pulmonary resection for bronchogenic carci noma to assess the value of lung perfusion scintigraphy for the predic tion of post-operative forced lung volumes and parameters on maximum e xercise, including maximum ventilation and maximum oxygen uptake. Nine patients were lost to follow-up, and these patients differed from the reinvestigated patients only in the staging of the pulmonary carcinom a and not in preoperative lung function or exercise capacity. We found a clear relationship between the values predicted from a preoperative perfusion scintigraphy, spirometry and a maximum exercise study and t he observed values measured 6 months post-operatively. The method unde restimated the postoperative values of both spirometric and exercise m easurements, especially in the higher range. Only in a few cases were the post-operative observed values less than the predicted values, and in these cases the difference was without clinical significance. Unex pected post-operative respiratory insufficiency was not observed. In c onclusion, in patients in whom a pulmonary resection was performed, no t only the post-operative spirometric values, but also the more functi onal related maximum exercise data can be predicted through the knowle dge of a preoperative perfusion scintigraphy.