Valutazione preoperatoria in chirurgia toracica

In the most recent years, the technical progress in surgery and in perisurgical, medical and rehabilitative, peri-operatory treatment has widened the indication to subjects at risk who once would be treated only with medical therapies. Aim of the paper is to identify the parameters which could give rise to an algorithm for the selection of patients to submit to invasive methods. Trie evaluation takes into consideration age, general condition, cardiocirculatory function with basal and post-exercise ECG, echocardiography and coronarography, respiratory function with spirometry, arterial blood gases, scintigraphic studies exercise, tests and xRays. Between the functional parameters, particular attention is put on FEV1, FEV1/FVC ratio, post-operatory FEV1, as such and after correction following perfusional lung scintigraphy, residual volume, diffusion capacity, walking test, exercise test with maximum O2 consumption.