Preoperative assessment for thoracic surgery

Preoperative assessment of thoracic surgical patients is a multidisciplinary process designed to offer appropriate surgical treatment with acceptable risk. Recently updated UK guidelines for pulmonary resection associated with malignant disease have reviewed available evidence concerning operative risk. Patients displaying cardiopulmonary physiological parameters above previously recommended threshold values remain classified as good risk. Less certainty now exists about the utility of predicted post-operative pulmonary function values and preoperative performance status to confer unacceptable risk. The new guidelines suggest a tripartite risk assessment combining risks of operative mortality, perioperative adverse cardiac events and postoperative dyspnoea – to be discussed by the multidisciplinary team and with the patient.