title: Video-assisted thoracoscopic lobectomy for non-small cell lung cancer in patients with severe chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To assess the feasibility, safety and long-term outcomes of video-assisted thoracic surgery (VATS) lobectomy for the treatment of non-small cell lung cancer (NSCLC) in patients with severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  The clinical data of patients with NSCLC and severe COPD (preoperative FEV1% <50%) who underwent VATS lobectomy from January 2000 to January 2011 were retrospectively analyzed to identify their demographic parameters, postoperative complications and outcomes.
  
  
  RESULTS
  The preoperative FEV1/FVC was <70% and FEV1% <50% in all 61 patients in this study, with a mean preoperative FEV1 of 0.99 L (0.54-1.58 L) and mean FEV1% of 38.4% (22-49.82%). All of the 61 patients underwent the VATS lobectomy or sleeve resection plus systemic lymph node dissection. The mean operative time was 218 minutes (120-355 minutes), with a mean intraoperative blood loss of 342 mL (50-1,600 mL). None of the patients converted to thoracotomy. Multivariate statistical analysis revealed that age and TNM staging after tumor resection were independent predictive factors for the 5-year survival in those patients (P=0.014 and 0.013).
  
  
  CONCLUSIONS
  With preoperative imaging studies, pulmonary function assessment and target positioning, VATS lobectomy can be safely and effectively performed for patients with NSCLC and severe COPD to achieve a satisfying long-term survival outcome.
authors.affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; ; Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou 510120, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Xu
authors.forename: Xinguo
authors.initials: X
authors.lastname: Xiong
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Yin
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Wenlong
authors.initials: W
authors.lastname: Shao
authors.forename: Hanzhang
authors.initials: H
authors.lastname: Chen
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
keywords: Non-small cell lung cancer (NSCLC); chronic obstructive pulmonary disease (COPD); lobectomy; video-assisted thoracic surgery (VATS)
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