Clinical study of simultaneous lung volume reduction surgery during resection of pulmonary or esophageal neoplasms.
BACKGROUND
If the emphysema lesions are not symmetrical, unilateral lung volume reduction surgery (LVRS) can be carried out on the more severe side. The aim of this research was to evaluate the feasibility and effects of LVRS performed simultaneously with resection of pulmonary and esophageal neoplasms.


METHODS
Forty-five patients with pulmonary neoplasm and 37 patients with esophageal neoplasm were randomly assigned to group A or group B. In group A, LVRS was performed simultaneously on the same side as thoracotomy. In group B, only tumor resection was performed. The nonfunctional lung area was determined by preoperative chest computed tomography and lung ventilation/perfusion scan. The lung volume removed was about 20% to 30% of the lobes on one side. Preoperative and postoperative indexes including pulmonary function testing variables, arterial blood gas analysis variables, dyspnea scale, 6-minute walk distance, etc., were compared between the groups.


RESULTS
There were no surgical deaths in this study. The postoperative forced vital capacity in 1 second, PaO2, PaCO2, dyspnea scale, and 6-minute walk distance were improved significantly in group A, whereas these indexes did not change or decreased slightly in group B.


CONCLUSIONS
For tumor patients who have associated emphysema, simultaneous LVRS not only increases the chance of receiving surgical therapy, but also improves the postoperative quality of life of the patient. LVRS has expanded the surgical indication for tumor patients.
Department of Chest Surgery, Yuhuangding Hospital, Yantai, Shandong 264000, China. chengdewang12@ msn.com
Yi-Jun
YJ
Tang
Chao-Yang
CY
Wang
Cheng-de
CD
Wang
Yao-Zhong
YZ
Dong
D000328:Adult; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011656:Pulmonary Emphysema / Q000601:surgery; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome