[Personal experience with the stress test before thoracic surgery procedures].
Physical loads can to a certain extent the surgical stress and postoperative load. Since 1987 the authors started to use loading tests when evaluating the surgical risk and during the preoperative preparation of patients before surgery of the lungs and before two-cavity operations in oesophageal disease. Since 1989 the authors used in patients 2-minute isotemporal graded submaximal loading tests on a bicycle ergometer with three-minute breaks between individual loads. The tested patients were high risk patients-ASA 3-4. From the investigation ensues that a major surgical operation greatly increases the specificity and reduces the false positivity of the preoperative loading examination. Detection of functional fitness or functional reserves of the cardiovascular and cardiopulmonary system before operation leads to a more aimed preoperative preparation and postoperative therapy. Indications for major surgery in high risk patients is according to the authors' experience an even more marked impulse for preoperative loading tests than the patient's age. In 60-year-old patients and older ones the loading tests are also very valuable from the clinical aspect; the authors, however, were not able to prove the necessity of routine testing of this group of patients before every surgical operation. In these instances in indication for a loading tests the opinion of the specialist for internal medicine will be decisive.