Situation
You are referred a patient for a right upper lobectomy for non small cell carcinoma. They are pretty fit but you notice on the CT scan that they have quite extensive bronchiectasis in the right lower lobe. What is going through your mind ?
Three points:
1. The lower lobe will be fibrotic so it may not expand well producing a space problem.
2. The chronic quite often infected secretions will predispose the patient to a post operative chest infection.
3. The gas transfer in the lower lobe may not be very good, so in a patient with marginal PFTs they may develop respiratory insufficiency post operatively.