You should always estimate postoperative FEV1 with the assumption that the patient is going to have pneumonectomy. On the operating table, the surgeon may encounter an unexpected node over the pulmonary artery requiring pneumonectomy for surgical cure. If by preoperative PFT evaluation, the patient is not considered a candidate for pneumonectomy, the surgeon should be appraised of that fact. He may be forced to close the chest without attempting a curative surgical resection.
Each segment approximately contributes to 5% of pulmonary function and one can calculate the amount of FEV1 loss based on the anticipated number of segments that are going to be removed. Knowing this information, you can calculate post-op FEV1 volume for cases requiring limited resection.
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