Document Detail


Is lung cancer surgery justified in patients with coronary artery disease?
MedLine Citation:
PMID:  8086174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between 1987 and 1992, 21 patients who presented with potentially resectable non-small cell lung cancer and coronary artery disease, underwent a preoperative cardiac catheterization in order to assess the coronary artery anatomy and left ventricular function. There were 20 men and 1 woman whose ages ranged from 57 to 77 years. Patients with triple-vessel disease and poor distal circulation or impaired ventricular function (n = 2) were excluded from myocardial revascularization and pulmonary surgery. Patients with a curable left-main or triple-vessel disease (group I) first underwent surgical (n = 3) or transluminal (n = 4) myocardial revascularization. The remaining patients presented with single- or double-vessel disease, and were operated on without prior myocardial revascularization (group II; n = 12). The thoracic procedures consisted of exploratory thoracotomy in two cases, lung-sparing resection in one, lobectomy in ten, bilobectomy in one and pneumonectomy in five. The overall mortality and morbidity rates were 5.3% and 31.6%, respectively. Four patients (21%) experienced postoperative cardiac complications: fatal myocardial infarction (n = 1) and dysrhythmia (n = 2) in three group II patients (25%), and transient myocardial ischemia in one group I patient (14.3%). The overall survival rate at 5 years was 57.4% for the 17 patients who underwent resection of their cancer. We conclude that 1) lung surgery in patients with non-small cell lung cancer and coronary artery disease is justified in selected cases, 2) previous myocardial revascularization appears to confer protection against the development of postoperative cardiac morbidity.
Authors:
P Thomas; R Giudicelli; J C Guillen; P Fuentes
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  8     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1994  
Date Detail:
Created Date:  1994-10-18     Completed Date:  1994-10-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  287-91; discussion 292     Citation Subset:  IM    
Affiliation:
Department of Thoracic Surgery, Sainte-Marguerite Hospital, Marseille, France.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / complications,  surgery
Aged
Carcinoma, Large Cell / complications,  surgery
Carcinoma, Non-Small-Cell Lung / complications,  mortality,  surgery*
Carcinoma, Squamous Cell / complications,  surgery
Coronary Disease / complications*,  surgery
Female
Humans
Lung Neoplasms / complications,  mortality,  surgery*
Male
Middle Aged
Myocardial Revascularization
Pneumonectomy
Postoperative Complications
Prognosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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