Original articleGeneral thoracicOperative Mortality and Respiratory Complications After Lung Resection for Cancer: Impact of Chronic Obstructive Pulmonary Disease and Time Trends
Section snippets
Patient Management
From January 1, 1990, to December 30, 2004, 1,239 consecutive thoracotomies for lung cancer (reinterventions, n = 31) were performed in two affiliated medical institutions: an academic center (Hôpitaux Universitaires de Genève [HUG]) and a regional hospital (Centre Valaisan de Pneumologie [CVP]) that covered an area with approximately 680,000 inhabitants.
Preoperatively, patients with borderline spirometric results (FEV1 lower than 60% of predicted), impaired exercise tolerance or cardiac risk
Results
From 1993 through 2004, completed data were obtained in 1,222 cases that were distributed in three groups: normal or mild impairment in pulmonary function tests (FEV1≥70%: n = 728, 60%), moderate COPD (FEV150% to 70%: n = 397, 32%), and severe COPD (FEV1<50%: n = 97, 8%).
Comment
Over a 15-year period, retrospective analysis of 1,222 patients operated on for lung cancer demonstrated that (1) moderate-to-severe COPD was documented in 40% of surgical candidates, (2) preoperative FEV1below a threshold of 60% carried a twofold to threefold increased risk for operative mortality and respiratory complications whereas TEA was a predictor of better short-term outcome, and (4) over the last 5 years, a higher proportion of lesser resection due to diagnosis of earlier pathologic
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