Lung reduction operation and resection of pulmonary nodules in patients with severe emphysema

Joseph DeRose, Michael Argenziano, Nabeel El-Amir, Patricia A. Jellen, Lyall A. Gorenstein, Kenneth M. Steinglass, Byron Thomashow, Mark E. Ginsburg

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background. Severe pulmonary dysfunction has been considered a relative contraindication to surgical resection in patients with solitary pulmonary nodules. We report our initial experience with the combined use of lung volume reduction operation and tumor resection in this patient population. Methods and patients. Between January 1995 and July 1996, 14 patients underwent combined lung volume reduction operation and pulmonary nodule resection. Ten (71%) patients were oxygen dependent, 5 (36%) had a room air partial pressure of carbon dioxide ≤ 45, and 5 (36%) were steroid dependent preoperatively. Mean preoperative pulmonary function tests included a forced expiratory volume in 1 second of 680 ± 98 mL (24% ± 5% predicted), forced vital capacity of 54% ± 5% predicted, and a forced expiratory volume in 1 second to vital capacity ratio of 37% ± 2% predicted. Results. Sixteen lesions were resected in the 14 patients and included 9 non-small cell carcinomas. There was one postoperative death. All other patients are alive and well through a mean follow-up of 22.6 ± 2.3 months (12 to 35 months). At 6-month follow-up improvements were noted in dyspnea index, forced expiratory volume in 1 second forced vital capacity, and 6-minute walk distance. Mediastinal recurrence at 12-month follow-up developed in 1 patient with two separate bronchioalveolar carcinomas. Conclusions. Simultaneous lung volume reduction operation and tumor resection should be considered in patients with emphysema with marginal reserve in the hope of maximizing postoperative lung function.

Original languageEnglish (US)
Pages (from-to)314-318
Number of pages5
JournalAnnals of Thoracic Surgery
Volume65
Issue number2
DOIs
StatePublished - 1998
Externally publishedYes

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Emphysema
Lung
Pneumonectomy
Vital Capacity
Forced Expiratory Volume
Solitary Pulmonary Nodule
Carcinoma
Air Pressure
Partial Pressure
Respiratory Function Tests
Carbon Dioxide
Dyspnea
Neoplasms
Steroids
Oxygen
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

DeRose, J., Argenziano, M., El-Amir, N., Jellen, P. A., Gorenstein, L. A., Steinglass, K. M., ... Ginsburg, M. E. (1998). Lung reduction operation and resection of pulmonary nodules in patients with severe emphysema. Annals of Thoracic Surgery, 65(2), 314-318. https://doi.org/10.1016/S0003-4975(97)01257-5

Lung reduction operation and resection of pulmonary nodules in patients with severe emphysema. / DeRose, Joseph; Argenziano, Michael; El-Amir, Nabeel; Jellen, Patricia A.; Gorenstein, Lyall A.; Steinglass, Kenneth M.; Thomashow, Byron; Ginsburg, Mark E.

In: Annals of Thoracic Surgery, Vol. 65, No. 2, 1998, p. 314-318.

Research output: Contribution to journalArticle

DeRose, J, Argenziano, M, El-Amir, N, Jellen, PA, Gorenstein, LA, Steinglass, KM, Thomashow, B & Ginsburg, ME 1998, 'Lung reduction operation and resection of pulmonary nodules in patients with severe emphysema', Annals of Thoracic Surgery, vol. 65, no. 2, pp. 314-318. https://doi.org/10.1016/S0003-4975(97)01257-5
DeRose, Joseph ; Argenziano, Michael ; El-Amir, Nabeel ; Jellen, Patricia A. ; Gorenstein, Lyall A. ; Steinglass, Kenneth M. ; Thomashow, Byron ; Ginsburg, Mark E. / Lung reduction operation and resection of pulmonary nodules in patients with severe emphysema. In: Annals of Thoracic Surgery. 1998 ; Vol. 65, No. 2. pp. 314-318.
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abstract = "Background. Severe pulmonary dysfunction has been considered a relative contraindication to surgical resection in patients with solitary pulmonary nodules. We report our initial experience with the combined use of lung volume reduction operation and tumor resection in this patient population. Methods and patients. Between January 1995 and July 1996, 14 patients underwent combined lung volume reduction operation and pulmonary nodule resection. Ten (71{\%}) patients were oxygen dependent, 5 (36{\%}) had a room air partial pressure of carbon dioxide ≤ 45, and 5 (36{\%}) were steroid dependent preoperatively. Mean preoperative pulmonary function tests included a forced expiratory volume in 1 second of 680 ± 98 mL (24{\%} ± 5{\%} predicted), forced vital capacity of 54{\%} ± 5{\%} predicted, and a forced expiratory volume in 1 second to vital capacity ratio of 37{\%} ± 2{\%} predicted. Results. Sixteen lesions were resected in the 14 patients and included 9 non-small cell carcinomas. There was one postoperative death. All other patients are alive and well through a mean follow-up of 22.6 ± 2.3 months (12 to 35 months). At 6-month follow-up improvements were noted in dyspnea index, forced expiratory volume in 1 second forced vital capacity, and 6-minute walk distance. Mediastinal recurrence at 12-month follow-up developed in 1 patient with two separate bronchioalveolar carcinomas. Conclusions. Simultaneous lung volume reduction operation and tumor resection should be considered in patients with emphysema with marginal reserve in the hope of maximizing postoperative lung function.",
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