Lung resection in patients with compromised pulmonary function

Robert J. Cerfolio, Mark S. Allen, Victor F. Trastek, Claude Deschamps, Paul D Scanlon, Peter C. Pairolero

Research output: Contribution to journalArticle

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Abstract

Background. Some patients are denied curative pulmonary resection for lung carcinoma because of pulmonary insufficiency. To identify factors that affect postoperative morbidity and mortality, we reviewed 85 consecutive patients (53 men and 32 women) with a preoperative forced expiratory volume in 1 second of less than 1.2 L who underwent pulmonary resection for lung cancer between January 1986 and December 1990. Methods. Median age was 70 years (range, 49 to 82 years). Sixty patients (71%) had been previously denied operation because of pulmonary insufficiency. Preoperative pulmonary function demonstrated a median preoperative forced expiratory volume in 1 second of 1.0 L (44% of predicted normal; range, 0.5 to 1.2 L) and a diffusing capacity of the lung for carbon monoxide of 60% of predicted normal (range, 22% to 104%). Results. Pneumonectomy was done in 6 patients (7.1%), bilobectomy in 6 (7.1%), lobectomy in 38 (44.7%), segmentectomy in 12 (14.1%), and wedge excision in 23 (27.1%). The median predicted postoperative forced expiratory volume in 1 second was 0.83 L (34% of predicted normal; range, 0.45 to 1.14 L), and the median predicted postoperative diffusing capacity of the lung for carbon monoxide was 48% of predicted normal (range, 19% to 87%). Seventy-two patients (85%) received postoperative epidural analgesia. Median hospitalization was 15 days (range, 5 to 66 days). Operative mortality was 2.4%, and complications occurred in 49%. We did not identify any factors that predicted postoperative morbidity and mortality. Median follow-up was 3.2 years (range, 0.2 to 9 years). Seven patients (8%) required supplemental home oxygen. A predicted postoperative percent forced expiratory volume in 1 second less than 43% correlated with the need for home oxygen (p < 0.05). Overall 5-year survival was 44.0%. Survival for stage I cancer was 54.2%; stage II, 33.1%; and stage IIIa, 21.3%. Conclusions. We conclude that some patients with lung cancer and compromised pulmonary function can safely undergo pulmonary resection if selected appropriately.

Original languageEnglish (US)
Pages (from-to)348-351
Number of pages4
JournalAnnals of Thoracic Surgery
Volume62
Issue number2
DOIs
StatePublished - Aug 1996

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Lung
Forced Expiratory Volume
Lung Volume Measurements
Carbon Monoxide
Mortality
Lung Neoplasms
Reference Values
Oxygen
Morbidity
Epidural Analgesia
Survival
Segmental Mastectomy
Pneumonectomy
Hospitalization
Carcinoma
Neoplasms

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Cerfolio, R. J., Allen, M. S., Trastek, V. F., Deschamps, C., Scanlon, P. D., & Pairolero, P. C. (1996). Lung resection in patients with compromised pulmonary function. Annals of Thoracic Surgery, 62(2), 348-351. https://doi.org/10.1016/0003-4975(96)00427-4

Lung resection in patients with compromised pulmonary function. / Cerfolio, Robert J.; Allen, Mark S.; Trastek, Victor F.; Deschamps, Claude; Scanlon, Paul D; Pairolero, Peter C.

In: Annals of Thoracic Surgery, Vol. 62, No. 2, 08.1996, p. 348-351.

Research output: Contribution to journalArticle

Cerfolio, RJ, Allen, MS, Trastek, VF, Deschamps, C, Scanlon, PD & Pairolero, PC 1996, 'Lung resection in patients with compromised pulmonary function', Annals of Thoracic Surgery, vol. 62, no. 2, pp. 348-351. https://doi.org/10.1016/0003-4975(96)00427-4
Cerfolio, Robert J. ; Allen, Mark S. ; Trastek, Victor F. ; Deschamps, Claude ; Scanlon, Paul D ; Pairolero, Peter C. / Lung resection in patients with compromised pulmonary function. In: Annals of Thoracic Surgery. 1996 ; Vol. 62, No. 2. pp. 348-351.
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abstract = "Background. Some patients are denied curative pulmonary resection for lung carcinoma because of pulmonary insufficiency. To identify factors that affect postoperative morbidity and mortality, we reviewed 85 consecutive patients (53 men and 32 women) with a preoperative forced expiratory volume in 1 second of less than 1.2 L who underwent pulmonary resection for lung cancer between January 1986 and December 1990. Methods. Median age was 70 years (range, 49 to 82 years). Sixty patients (71{\%}) had been previously denied operation because of pulmonary insufficiency. Preoperative pulmonary function demonstrated a median preoperative forced expiratory volume in 1 second of 1.0 L (44{\%} of predicted normal; range, 0.5 to 1.2 L) and a diffusing capacity of the lung for carbon monoxide of 60{\%} of predicted normal (range, 22{\%} to 104{\%}). Results. Pneumonectomy was done in 6 patients (7.1{\%}), bilobectomy in 6 (7.1{\%}), lobectomy in 38 (44.7{\%}), segmentectomy in 12 (14.1{\%}), and wedge excision in 23 (27.1{\%}). The median predicted postoperative forced expiratory volume in 1 second was 0.83 L (34{\%} of predicted normal; range, 0.45 to 1.14 L), and the median predicted postoperative diffusing capacity of the lung for carbon monoxide was 48{\%} of predicted normal (range, 19{\%} to 87{\%}). Seventy-two patients (85{\%}) received postoperative epidural analgesia. Median hospitalization was 15 days (range, 5 to 66 days). Operative mortality was 2.4{\%}, and complications occurred in 49{\%}. We did not identify any factors that predicted postoperative morbidity and mortality. Median follow-up was 3.2 years (range, 0.2 to 9 years). Seven patients (8{\%}) required supplemental home oxygen. A predicted postoperative percent forced expiratory volume in 1 second less than 43{\%} correlated with the need for home oxygen (p < 0.05). Overall 5-year survival was 44.0{\%}. Survival for stage I cancer was 54.2{\%}; stage II, 33.1{\%}; and stage IIIa, 21.3{\%}. Conclusions. We conclude that some patients with lung cancer and compromised pulmonary function can safely undergo pulmonary resection if selected appropriately.",
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AU - Cerfolio, Robert J.

AU - Allen, Mark S.

AU - Trastek, Victor F.

AU - Deschamps, Claude

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AU - Pairolero, Peter C.

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N2 - Background. Some patients are denied curative pulmonary resection for lung carcinoma because of pulmonary insufficiency. To identify factors that affect postoperative morbidity and mortality, we reviewed 85 consecutive patients (53 men and 32 women) with a preoperative forced expiratory volume in 1 second of less than 1.2 L who underwent pulmonary resection for lung cancer between January 1986 and December 1990. Methods. Median age was 70 years (range, 49 to 82 years). Sixty patients (71%) had been previously denied operation because of pulmonary insufficiency. Preoperative pulmonary function demonstrated a median preoperative forced expiratory volume in 1 second of 1.0 L (44% of predicted normal; range, 0.5 to 1.2 L) and a diffusing capacity of the lung for carbon monoxide of 60% of predicted normal (range, 22% to 104%). Results. Pneumonectomy was done in 6 patients (7.1%), bilobectomy in 6 (7.1%), lobectomy in 38 (44.7%), segmentectomy in 12 (14.1%), and wedge excision in 23 (27.1%). The median predicted postoperative forced expiratory volume in 1 second was 0.83 L (34% of predicted normal; range, 0.45 to 1.14 L), and the median predicted postoperative diffusing capacity of the lung for carbon monoxide was 48% of predicted normal (range, 19% to 87%). Seventy-two patients (85%) received postoperative epidural analgesia. Median hospitalization was 15 days (range, 5 to 66 days). Operative mortality was 2.4%, and complications occurred in 49%. We did not identify any factors that predicted postoperative morbidity and mortality. Median follow-up was 3.2 years (range, 0.2 to 9 years). Seven patients (8%) required supplemental home oxygen. A predicted postoperative percent forced expiratory volume in 1 second less than 43% correlated with the need for home oxygen (p < 0.05). Overall 5-year survival was 44.0%. Survival for stage I cancer was 54.2%; stage II, 33.1%; and stage IIIa, 21.3%. Conclusions. We conclude that some patients with lung cancer and compromised pulmonary function can safely undergo pulmonary resection if selected appropriately.

AB - Background. Some patients are denied curative pulmonary resection for lung carcinoma because of pulmonary insufficiency. To identify factors that affect postoperative morbidity and mortality, we reviewed 85 consecutive patients (53 men and 32 women) with a preoperative forced expiratory volume in 1 second of less than 1.2 L who underwent pulmonary resection for lung cancer between January 1986 and December 1990. Methods. Median age was 70 years (range, 49 to 82 years). Sixty patients (71%) had been previously denied operation because of pulmonary insufficiency. Preoperative pulmonary function demonstrated a median preoperative forced expiratory volume in 1 second of 1.0 L (44% of predicted normal; range, 0.5 to 1.2 L) and a diffusing capacity of the lung for carbon monoxide of 60% of predicted normal (range, 22% to 104%). Results. Pneumonectomy was done in 6 patients (7.1%), bilobectomy in 6 (7.1%), lobectomy in 38 (44.7%), segmentectomy in 12 (14.1%), and wedge excision in 23 (27.1%). The median predicted postoperative forced expiratory volume in 1 second was 0.83 L (34% of predicted normal; range, 0.45 to 1.14 L), and the median predicted postoperative diffusing capacity of the lung for carbon monoxide was 48% of predicted normal (range, 19% to 87%). Seventy-two patients (85%) received postoperative epidural analgesia. Median hospitalization was 15 days (range, 5 to 66 days). Operative mortality was 2.4%, and complications occurred in 49%. We did not identify any factors that predicted postoperative morbidity and mortality. Median follow-up was 3.2 years (range, 0.2 to 9 years). Seven patients (8%) required supplemental home oxygen. A predicted postoperative percent forced expiratory volume in 1 second less than 43% correlated with the need for home oxygen (p < 0.05). Overall 5-year survival was 44.0%. Survival for stage I cancer was 54.2%; stage II, 33.1%; and stage IIIa, 21.3%. Conclusions. We conclude that some patients with lung cancer and compromised pulmonary function can safely undergo pulmonary resection if selected appropriately.

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