Role of diffusing capacity in predicting complications after lung resection for cancer.

Background: The purpose of our study was to determine whether the assessment of the diffusing capacity of the lung for carbon monoxide (DL CO), together with the forced expiratory volume in 1 second (FEV 1), could improve the selection of surgical patients. Methods: The data of 76 patients undergoing major lung resection (pnemonectomy, bilobectomy or lobectomy) for non-small cell lung cancer were retrospectively studied. All patients were reviewed for age, sex, preexisting medical conditions, operative, and pathological findings and postoperative outcome. Results: Univariate and multivariable logistic regression analysis showed that ppoFEV1 and ppoDLCO were the only statistically significant predictors of pulmonary complications. In the group of patients with marginal ppoFEV 1 (between 30-40%), ppoDLCO predicted pulmonary morbidity with a better accuracy (p 0.05). Multiple regression analysis showed that pneumonectomy was the only statistical factor correlated with mortality (p < 0.05). Conclusion: Our experience seems to suggest that ppoDLCO is a strong predictor of pulmonary complications after major lung resection, allowing a better surgical selection of the patients with compromised respiratory function. © Georg Thieme Verlag KG Stuttgart