Thoracics pre-op workup

Pre-op

• Quit smoking 4-8 weeks pre-op to reduce incidence of complications (minimum 2 weeks)
• RFTs
  • FEV1 > 60% can generally tolerate an anatomic lobectomy
  • Predicted post-op FEV1 can be estimated - those with 35-40% should tolerate the operation. Any less and high risk of pulmonary complications.
  • DLCO - diffusing capacity measured via transfer of carbon monoxide from inspired air to the bloodstream
  • Quantitative radionucleotide lung perfusion measures the relative function of each lobe

Post-op

• Incentive spirometry
• Early mobilisation
• Good pain control
• Nasal BIPAP for those with OSA