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Lung resection in patients with compromised pulmonary function

R J Cerfolio1, M S Allen, V F Trastek

  • 1Section of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

The Annals of Thoracic Surgery
|August 1, 1996
PubMed
Summary
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Patients with lung cancer and poor pulmonary function can safely undergo surgery. Careful patient selection is key to successful outcomes and survival rates.

Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Surgical Oncology

Background:

  • Lung cancer patients with pulmonary insufficiency often face denial of curative resection.
  • This study reviewed 85 patients with low forced expiratory volume in 1 second (FEV1) undergoing pulmonary resection.
  • Many of these patients (71%) were initially denied surgery due to respiratory limitations.

Purpose of the Study:

  • To identify factors influencing postoperative morbidity and mortality in lung cancer patients with compromised pulmonary function.
  • To assess the safety and outcomes of pulmonary resection in carefully selected patients with reduced lung function.

Main Methods:

  • Retrospective review of 85 lung cancer patients with preoperative FEV1 < 1.2 L.
  • Analysis of preoperative pulmonary function tests, including FEV1 and diffusing capacity for carbon monoxide (DLCO).

Related Experiment Videos

  • Evaluation of surgical procedures, postoperative outcomes, complications, survival rates, and need for home oxygen.

    • Main Results:

    • Operative mortality was low (2.4%), with 49% experiencing complications.
    • Predicted postoperative FEV1 was 0.83 L (34% of predicted), and DLCO was 48% of predicted.
    • A predicted postoperative FEV1 < 43% correlated with the need for home oxygen. Overall 5-year survival was 44.0%.

    Conclusions:

    • Pulmonary resection can be safely performed in selected lung cancer patients with significant pulmonary compromise.
    • Appropriate patient selection is crucial for minimizing risks and achieving favorable outcomes.
    • This approach expands treatment options for patients previously considered inoperable.