Preoperative Evaluation for Lung Resection Surgery

Purpose of Review The purpose of this article is to review the literature surrounding preoperative assessment and management of patients undergoing lung resection surgery. Recent Findings The traditional preoperative cardiovascular risk assessment can be further refined in patients undergoing lung resection surgery with the Thoracic Revised Cardiac Risk Index and cardiac biomarkers such as B-type natriuretic peptide. Cardiorespiratory exercise testing parameters such as the maximal achieved oxygen consumption (VO2 peak) and the minute ventilation to carbon dioxide output (VE/VCO2) slope are strong preoperative prognosticators in patients with borderline lung function. Preoperative pulmonary rehabilitation holds promising benefits in improving surgical candidacy and postoperative outcomes. Summary The preoperative assessment of lung resection candidates must evaluate perioperative cardiorespiratory risk. The patient's comorbidities should be optimized as time permits. A clear perioperative plan should be established and may include cardiology consultation, prevention strategies for arrhythmias, preoperative pulmonary rehabilitation, smoking cessation, intensive perioperative monitoring, and enhanced recovery protocols.