title: Video-assisted thoracic surgery pulmonary resection for lung cancer in patients with poor lung function.
abstract: BACKGROUND
  The aim of this study is to evaluate the early outcome of patients with poor lung function who underwent video-assisted thoracic surgery (VATS) pulmonary resection for primary non-small cell lung carcinoma.
  
  
  METHODS
  We reviewed retrospectively the records of patients with lung cancer undergoing VATS lung resection over a period of 5 years. Twenty-five patients with preoperative poor lung function defined as forced expiratory volume in 1 second less than 0.8 L or the percentage predicted value for forced expiratory volume in 1 second less than 50% were identified. Thirteen patients underwent VATS lobectomies and 12 VATS wedge resections. Data were analyzed with respect to demographics, risk factors, and early postoperative outcome and survival.
  
  
  RESULTS
  There were 8 cases of morbidities (29%) and no surgical mortality. Five of these 8 patients had respiratory-related complications after surgery. A deterioration in pulmonary performance as indicated by the Eastern Cooperative Oncology Group (ECOG) score was seen in 7 patients (28%), with only 1 patient having an ECOG score greater than 2. No patient required home oxygen supplementation beyond the third month postoperatively. After a median follow-up period of 15.1 months (range, 1 to 24), 5 patients died. Only 1 patient (4%) died of a respiratory complication (pneumonia 6 weeks after surgery). The other 4 deaths were due to recurrent or metastatic disease. The actuarial survival rates at 1 and 2 years were 80% and 69%, respectively.
  
  
  CONCLUSIONS
  Video-assisted thoracic surgery pulmonary resection for cancer in patients with poor lung function can achieve acceptable functional and oncologic outcome.
authors.affiliation: Division of Cardiothoracic Surgery, Chinese University of Hong Kong, Minimally Invasive Surgery Center, Union Hospital, Hong Kong, China.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Garzon
authors.forename: Calvin S H
authors.initials: CS
authors.lastname: Ng
authors.forename: Alan D L
authors.initials: AD
authors.lastname: Sihoe
authors.forename: Anthony V
authors.initials: AV
authors.lastname: Manlulu
authors.forename: Randolph H L
authors.initials: RH
authors.lastname: Wong
authors.forename: Tak Wai
authors.initials: TW
authors.lastname: Lee
authors.forename: Anthony P C
authors.initials: AP
authors.lastname: Yim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D015993:Life Tables; D008175:Lung Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D011013:Pneumonectomy / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000706:statistics & numerical data; D016896:Treatment Outcome