Video-assisted thoracic surgery pulmonary resection for lung cancer in patients with poor lung function.
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.
Garzon
Juan C
JC
Division of Cardiothoracic Surgery, Chinese University of Hong Kong, Minimally Invasive Surgery Center, Union Hospital, Hong Kong, China.
Ng
Calvin S H
CS
Sihoe
Alan D L
AD
Manlulu
Anthony V
AV
Wong
Randolph H L
RH
Lee
Tak Wai
TW
Yim
Anthony P C
AP
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