Is Measurement of Lung Function Helpful in Assessing Risk of Esophagectomy?

Postoperative pulmonary complications are a major driver of overall morbidity and mortality after esophagectomy. Consequently, the prediction of risk and prevention of respiratory morbidity is of major importance, and in this context the evaluation of pulmonary physiology complements preoperative assessment. Pulmonary function testing is useful in the planning of neoadjuvant chemoradiation for patients with esophageal cancer, as modern neoadjuvant regimens have been shown to impact lung function, with implications for treatment tolerance and health-related quality of life in survivorship. Furthermore, pulmonary function testing may inform anesthetic and surgical approach, while poor pulmonary function is predictive for specific postoperative pulmonary complications and major morbidity after esophagectomy. This chapter aims to provide a comprehensive review of current evidence and recommendations for the use of pulmonary function testing as a component of multimodal risk assessment among patients planned for esophagectomy.