doiSerbia

Surgical treatment of patients with lung cancer and limited lung function: Preoperative assessment, operative mortality and morbidity

Subotić Dragan (Klinika za grudnu hirurgiju, Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd)
Mandarić Dragan (Klinika za grudnu hirurgiju, Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd)
Andrić Ljiljana (Klinika za grudnu hirurgiju, Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd)
Gajić Milan (Institut za socijalnu medicinu i statistiku, Medicinski fakultet, Beograd)
Eminović Tatjana (Klinika za grudnu hirurgiju, Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd)
Atanasijadis Nikola (Klinika za grudnu hirurgiju, Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd)
Dželetović Predrag (Klinika za grudnu hirurgiju, Institut za plućne bolesti i tuberkulozu, Klinički centar Srbije, Beograd)

Introduction: Lung resection in patients with limited lung function is one of the greatest challenges in general thoracic surgery. Objective. The aim of the study was to analyze the pattern of lung function changes after operation, operative morbidity and mortality and to compare them with control group of patients. Method. The study included 34 patients with limited lung function, operated for primary lung cancer in one-year period. All patients underwent preoperative desobstructive treatment. The type of ventilatory disorder was analyzed depending on preoperative radiographic and bronchoscopic aspect. Statistics: chisquare test, t-test. Results. In patients with lobectomy, the mean difference in forced expiratory volume in the first second (FEV1) between preoperative and postoperative values was 16.81%, whilst in the pneumonectomy group this difference was 39.51%. The mean change in forced vital capacity (FVC) in the lobectomy and pneumonectomy group was 15.83% and 42.73% respectively. In the control group of 28 patients with lobectomy, the decrease in FVC and FEV1 was 19.9% and 24.18% respectively. In the control group of 28 patients with pneumonectomy, the decrease in FVC and FEV1 was 43.52% and 41.36% respectively. In patients with limited lung function and lobectomy, changes in FEV1 and VC after resection were significantly lower compared to the control group of patients with lobectomy and normal lung function. None of 34 operated patients with borderline lung function died inside 30 postoperative days. In the same period, of a total number of 344 patients without respiratory function impairment, operative mortality was 3.1%. In the analyzed group, operative morbidity was 32.35%. Cardiovascular and respiratory complications in the analyzed and control groups occurred in 14.7% and 6.1% of patients respectively (p>0.05). Conclusion. Surgery should not be excluded in patients with borderline lung function prior to preoperative treatment and additional lung function assessment. .

Keywords: lung cancer, limited lung function, surgical treatment