Pulmonary resection combined with cardiac operations.
Surgical management of patients with concomitant critical cardiac disease and resectable lung lesions is controversial. During a 7-year period (1982 to 1988), 21 patients underwent combined cardiac and pulmonary operations. Patients had cardiac symptoms only; the lung lesions were found on preoperative chest roentgenograms. The pathological diagnosis was established in only 2 of the patients before operation. All underwent concurrent pulmonary resection during cardiac operations requiring extracorporeal circulation. The pulmonary operations included 17 wedge resections and four lobectomies. The final diagnoses in 8 patients with stage I non-small cell lung cancer included epidermoid carcinoma (4), adenocarcinoma (3), and bronchoalveolar carcinoma (1). Postoperatively, 1 patient required a permanent pacemaker and 1 patient died. The actuarial survival at 5 years for all patients who underwent combined procedures was 95%. The 5-year survival for the 8 patients with lung cancer was 88% compared with 100% for those with benign pulmonary pathology (p = 0.172). This experience suggests that combining pulmonary resection with cardiac operations is safe and offers a favorable prognosis to a select group of patients.
Canver
C C
CC
Department of Surgery, State University of New York, Buffalo 14203.
Bhayana
J N
JN
Lajos
T Z
TZ
Raza
S T
ST
Lewin
A N
AN
Bergsland
J
J
Mentzer
R M
RM
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013529:Surgical Wound Dehiscence / Q000209:etiology; D015996:Survival Rate; D013997:Time Factors