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Juan C. Garzon
Calvin S.H. Ng
Alan D.L. Sihoe
Anthony V. Manlulu
Randolph H.L. Wong
Anthony P.C. Yim
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Right arrow Lung - cancer

Ann Thorac Surg 2006;81:1996-2003
© 2006 The Society of Thoracic Surgeons

Original article: General thoracic

Video-Assisted Thoracic Surgery Pulmonary Resection for Lung Cancer in Patients with Poor Lung Function

Juan C. Garzon, MD, Calvin S.H. Ng, MBBS, Alan D.L. Sihoe, MBBChir, Anthony V. Manlulu, MD, Randolph H.L. Wong, MBChB, Tak Wai Lee, MBChB, Anthony P.C. Yim, MD, FRCS *

Division of Cardiothoracic Surgery, Chinese University of Hong Kong and Minimally Invasive Surgery Center, Union Hospital, Hong Kong, China

Accepted for publication January 5, 2006.

* Address correspondence to Dr Yim, Division of Cardiothoracic Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Minimally Invasive Center, Union Hospital, Shatin, NT, Hong Kong SAR, China (Email: yimap{at}cuhk.edu.hk).

BACKGROUND: The aim of this study is to evaluate the early outcome of patients with poor lung function who underwent video-assisted thoracic surgery (VATS) pulmonary resection for primary non-small cell lung carcinoma.

METHODS: We reviewed retrospectively the records of patients with lung cancer undergoing VATS lung resection over a period of 5 years. Twenty-five patients with preoperative poor lung function defined as forced expiratory volume in 1 second less than 0.8 L or the percentage predicted value for forced expiratory volume in 1 second less than 50% were identified. Thirteen patients underwent VATS lobectomies and 12 VATS wedge resections. Data were analyzed with respect to demographics, risk factors, and early postoperative outcome and survival.

RESULTS: There were 8 cases of morbidities (29%) and no surgical mortality. Five of these 8 patients had respiratory-related complications after surgery. A deterioration in pulmonary performance as indicated by the Eastern Cooperative Oncology Group (ECOG) score was seen in 7 patients (28%), with only 1 patient having an ECOG score greater than 2. No patient required home oxygen supplementation beyond the third month postoperatively. After a median follow-up period of 15.1 months (range, 1 to 24), 5 patients died. Only 1 patient (4%) died of a respiratory complication (pneumonia 6 weeks after surgery). The other 4 deaths were due to recurrent or metastatic disease. The actuarial survival rates at 1 and 2 years were 80% and 69%, respectively.

CONCLUSIONS: Video-assisted thoracic surgery pulmonary resection for cancer in patients with poor lung function can achieve acceptable functional and oncologic outcome.




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