1．呼吸機能障害合併患者の周術期管理の留意点

Considerations for Perioperative Management of Patients with Complicated Respiratory Dysfunction

本稿では，呼吸器外科医が手術を行う際に問題となりうる呼吸機能障害の代表的疾患である，慢性閉塞性肺疾患（COPD）および間質性肺疾患，特に特発性肺線維症（IPF）を合併した患者に特有な周術期合併症，術前リスク評価および周術期管理について説明する．

This article describes the perioperative complications, perioperative risk assessment, and perioperative management of patients with chronic obstructive pulmonary disease （COPD） and interstitial lung disease, especially idiopathic pulmonary fibrosis （IPF）, which are the leading diseases in respiratory dysfunction. In COPD, testing for forced expiratory volume during the first second and pulmonary diffusing capacity is important and an algorithm for testing has been presented by the Japanese Association for Chest Surgery. Acute exacerbation of IPF is the leading cause of postoperative mortality in Japan, and risk factors are being analyzed. To reduce the occurrence of postoperative complications, it is important to carry out a risk assessment, select appropriate surgical strategy, and implement a well-planned perioperative management.