Thoracic Surgery

Lung resection, pleural procedures, mediastinal surgery, and chest wall reconstruction

Patient: Arjun Reddy, 62M
UHID: UH-2026-0805
Diagnosis: Right lower lobe adenocarcinoma — clinical T2aN0M0
Histology: Adenocarcinoma (core biopsy — CT guided)
Molecular: EGFR wild-type, ALK negative, PD-L1 40%
TNM Stage: Stage IB — resectable

Pre-Surgical Assessment

ParameterValueAssessment
FEV1 (pre-op)2.1 L (68% predicted)Borderline — ppoFEV1 RLL lobectomy 1.54L (≥40% threshold met)
FVC2.8 L (70% predicted)Acceptable
DLCO62% predictedMildly reduced — ppo DLCO ≥40%
6MWT430 mAcceptable (≥400m = low risk)
Cardiac (ECHO)EF 55%, no RWMANo cardiac contraindication
Nutritional statusBMI 22, albumin 3.8Adequate
Smoking statusEx-smoker — stopped 4 weeks agoReduced surgical risk
Operative Risk:
Intermediate
Thoracic MDT Decision:
VATS Lobectomy (RLL)

Surgical Plan & Consent