TEMPORARY MAIN BRONCHIAL OCCLUSION UNDER BRONCHOSCOPIC CONTROL IN THEEVALUATION OF CANDIDATES FOR PNEUMONECTOMY

Background. In this study ne report our experience with temporary main bronchial occlusion in the preoperative evaluation of candidates for pneumonectomy. Methods, Between January 1991 and January 1994, 57 cand idates for pneumonectomy underwent a 15-minute temporary main bronchia l occlusion with an inflatable balloon during fiberoptic bronchoscopy, The following parameters were monitored during bronchial occlusion: g eneral status, EGG, arterial pressure, heart rate and respiratory rate , Arterial blood gases were measured after 7 and 11 minutes, Values at 7 and at 14 minutes were compared with those obtained before the proc edure, Patients were considered suitable surgical candidates for pneum onectomy if PaCO2<42 mmHg and pH>7.35. Results, Fifty-three patients w ere considered functionally operable, Three patients were considered f unctionally inoperable (PaCO2>42 mmHg, pH<7.35 and appearance of dyspn ea). One patient was excluded from the analysis because of balloon mis positioning due to a coughing fit, Sixteen of the operable patients un derwent pneumonectomy and all did well without clinical evidence of re spiratory insufficiency, At present 11 patients are alive, all without chronic respiratory insufficiency (mean follow-up 11 months), No post operative mortality related to cardiorespiratory problems was observed , Conclusions, Temporary main bronchial occlusion is a simple and inex pensive test that can correctly predict functional resectability in ca ndidates for pneumonectomy.