HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Joel D. Cooper Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DeMeester, S. R. Articles by Cooper, J. D. Search for Related Content PubMed PubMed Citation Articles by DeMeester, S. R. Articles by Cooper, J. D.

J Thorac Cardiovasc Surg 1998;115:681-685
© 1998 Mosby, Inc.

GENERAL THORACIC SURGERY

Lobectomy Combined With Volume Reduction For Patients With Lung Cancer And Advanced Emphysema

From the Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Mo., and (*current address) the Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif.

Received for publication April 10, 1997; revisions requested July 15, 1997; revisions received Oct. 16, 1997; accepted for publication Oct. 16, 1997. Address for reprints: Joel D. Cooper, MD, Division of Cardiothoracic Surgery, Washington University School of Medicine, One Barnes Hospital Plaza, 3108 Queeny Tower, St. Louis, MO 63110.

Objective: Early-stage lung cancer is best treated by anatomic pulmonary resection. Patients with lung cancer and severe emphysema are often denied resection or are offered only limited, nonanatomic resections when established pulmonary function criteria for lobectomy are not met. Recently, with the introduction of the volume reduction operation, selected patients with disabling emphysema have undergone excision of approximately 30% of the most destroyed lung tissue and have subsequently demonstrated subjective and objective improvement in pulmonary function. Using these principles, we elected to combine anatomic lobectomy with volume reduction in a select group of patients with both emphysema and lung cancer who would not otherwise be candidates for pulmonary resection.
Methods: Five patients with severe emphysema and suspected or proven lung cancers, who were poor candidates for anatomic lobectomy by traditional criteria but were good candidates for volume reduction, underwent lobectomy combined with volume reduction of one or more additional lobes.
Results: All five patients having lung volume reduction and anatomic lobectomy for early-stage primary lung cancer did well postoperatively. Furthermore, each patient has demonstrated subjective and objective improvement in respiratory function on serial postoperative studies.
Conclusions: Selected patients with disabling emphysema and suitable anatomy for volume reduction, who have a lung cancer situated in destroyed lung tissue, may benefit from combined lobectomy and volume reduction. The introduction of the volume reduction operation has added a new factor in the algorithm for the evaluation and treatment of lung cancer in selected patients with advanced emphysema.

This article has been cited by other articles:

				N. Patel, M. DeCamp, and G. J. Criner Lung Transplantation and Lung Volume Reduction Surgery versus Transplantation in Chronic Obstructive Pulmonary Disease Proceedings of the ATS, May 1, 2008; 5(4): 447 - 453. [Abstract] [Full Text] [PDF]

				G. L. Colice, S. Shafazand, J. P. Griffin, R. Keenan, and C. T. Bolliger Physiologic Evaluation of the Patient With Lung Cancer Being Considered for Resectional Surgery: ACCP Evidenced-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 161S - 177S. [Abstract] [Full Text] [PDF]

				G. Varela, A. Brunelli, G. Rocco, M. F. Jimenez, M. Salati, and T. Gatani Evidence of Lower Alteration of Expiratory Volume in Patients With Airflow Limitation in the Immediate Period After Lobectomy Ann. Thorac. Surg., August 1, 2007; 84(2): 417 - 422. [Abstract] [Full Text] [PDF]

				A. E Martin-Ucar, K. R Fareed, A. Nakas, P. Vaughan, J. G Edwards, and D. A Waller Is the initial feasibility of lobectomy for stage I non-small cell lung cancer in severe heterogeneous emphysema justified by long-term survival? Thorax, July 1, 2007; 62(7): 577 - 580. [Abstract] [Full Text] [PDF]

				S. Baldi, E. Ruffini, S. Harari, G. C. Roviaro, M. Nosotti, N. Bellaviti, F. Venuta, D. Diso, F. Rea, C. Schiraldi, et al. Does lobectomy for lung cancer in patients with chronic obstructive pulmonary disease affect lung function? A multicenter national study J. Thorac. Cardiovasc. Surg., December 1, 2005; 130(6): 1616 - 1622. [Abstract] [Full Text] [PDF]

				S. Matsuoka, Y. Kurihara, K. Yagihashi, H. Niimi, and Y. Nakajima Peripheral Solitary Pulmonary Nodule: CT Findings in Patients with Pulmonary Emphysema Radiology, April 1, 2005; 235(1): 266 - 273. [Abstract] [Full Text] [PDF]

				C. K. Choong, B. F. Meyers, R. J. Battafarano, T. J. Guthrie, G. E. Davis, G. A. Patterson, and J. D. Cooper Lung cancer resection combined with lung volume reduction in patients with severe emphysema J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1323 - 1331. [Abstract] [Full Text] [PDF]

				E. Pompeo, E. De Dominicis, V. Ambrogi, D. Mineo, S. Elia, and T. C. Mineo Quality of life after tailored combined surgery for stage I non-small-cell lung cancer and severe emphysema Ann. Thorac. Surg., December 1, 2003; 76(6): 1821 - 1827. [Abstract] [Full Text] [PDF]

				J. R. Burke, I. G. Duarte, V. H. Thourani, and J. I. Miller Jr Preoperative risk assessment for marginal patients requiring pulmonary resection Ann. Thorac. Surg., November 1, 2003; 76(5): 1767 - 1773. [Abstract] [Full Text] [PDF]

				Y. Sekine, T. Iwata, M. Chiyo, K. Yasufuku, S. Motohashi, S. Yoshida, M. Suzuki, T. Iizasa, Y. Saitoh, and T. Fujisawa Minimal alteration of pulmonary function after lobectomy in lung cancer patients with chronic obstructive pulmonary disease Ann. Thorac. Surg., August 1, 2003; 76(2): 356 - 361. [Abstract] [Full Text] [PDF]

				T. Fujimoto, H. Teschler, L. Hillejan, G. Zaboura, and G. Stamatis Long-term results of lung volume reduction surgery Eur. J. Cardiothorac. Surg., March 1, 2002; 21(3): 483 - 488. [Abstract] [Full Text] [PDF]

				L. Santambrogio, M. Nosotti, A. Baisi, G. Ronzoni, N. Bellaviti, and L. Rosso Pulmonary lobectomy for lung cancer: a prospective study to compare patients with forced expiratory volume in 1 s more or less than 80% of predicted Eur. J. Cardiothorac. Surg., October 1, 2001; 20(4): 684 - 687. [Abstract] [Full Text] [PDF]

				J G Edwards, D J R Duthie, and D A Waller Lobar volume reduction surgery: a method of increasing the lung cancer resection rate in patients with emphysema Thorax, October 1, 2001; 56(10): 791 - 795. [Abstract] [Full Text] [PDF]

				V. Ambrogi, E. Pompeo, G. Matteucci, and T. C. Mineo Combined surgery for emphysema and lung cancer Eur. J. Cardiothorac. Surg., September 1, 2000; 18(3): 372 - 374. [Full Text] [PDF]

				A. Carretta, P. Zannini, A. Puglisi, G. Chiesa, A. Vanzulli, A. Bianchi, A. Fumagalli, and S. Bianco Improvement of pulmonary function after lobectomy for non-small cell lung cancer in emphysematous patients Eur. J. Cardiothorac. Surg., May 1, 1999; 15(5): 602 - 607. [Abstract] [Full Text] [PDF]