[Limited operation for lung cancer]

The availability of a limited operation for the treatment of primary lung cancer was discussed on 67 cases who underwent either wedge resection or segmentectomy. The reasons for the application of limited operation were mainly cardiopulmonary failures such as hypertension, abnormal finding on the ECG and obstructive ventilatory failure including the elderly over 70 years of age. Favorable prognosis of a limited operation was obtained in T1N0 and T2N0 cancer when compared to those who underwent lobectomy. Improved prognosis following a limited operation was more attributable to N-factor rather than T. Furthermore, early postoperative course and performance status after a limited operation were more favorable rather than lobectomy. In particular, on the first day of a limited operation, hemodynamic changes in an increased afterload of the right ventricle and reduced left ventricular work tend to minimize in patients with a limited operation. An experimental study also elucidated the advantage of this operative procedure in terms of cardiac function after one or bilobectomy on coronary diseased dogs whose descending coronary artery was made to be a 50% stenosis. In conclusion, it was emphasized that a limited operation should be indicated for patients with T1N0 and T2N0 cancers of primary lung cancer and limited cardiopulmonary function.