Anatomical lung resection in patients with severely impaired pulmonary function
Abstract Background Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) and expected transfer factor for CO (TLCO) values < 30–35% are often considered to be a contraindication for anatomical lung resection in patients with lung cancer. Based on our prior positive experience in lung...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-08-01
|
| Series: | The Egyptian Journal of Bronchology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43168-025-00444-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849333590388637696 |
|---|---|
| author | Tomoyuki Nakagiri Hayan Merhej Akylbek Saipbaev Alaa Selman Heiko Golpon Tobias Goecke Arjang Ruhparwar Patrick Zardo |
| author_facet | Tomoyuki Nakagiri Hayan Merhej Akylbek Saipbaev Alaa Selman Heiko Golpon Tobias Goecke Arjang Ruhparwar Patrick Zardo |
| author_sort | Tomoyuki Nakagiri |
| collection | DOAJ |
| description | Abstract Background Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) and expected transfer factor for CO (TLCO) values < 30–35% are often considered to be a contraindication for anatomical lung resection in patients with lung cancer. Based on our prior positive experience in lung volume reduction surgery (LVRS), we retrospectively analyzed all patients with impaired pulmonary function undergoing anatomical minimally-invasive lung resection, either for LVRS or treatment of non-small cell lung cancer (NSCLC) at our institute. Methods From August 2016 to April 2021, n = 42 consecutive anatomical lung resections were performed in patients with poor lung function (< 35% ppoFEV1). We retrospectively searched our records and investigated the patients’ pre- and postoperative conditions and their outcome. Results We included 16 patients (9 males, age 68.4 ± 8.9 years old) scheduled for lung cancer surgery. The procedures were performed via uniportal video assisted thoracoscopic surgery (VATS; n = 10, 62.5%, including one non-intubated VATS) or via thoracotomy (n = 6, 37.5%) and included lobectomy (9 patients, 55.3%) or (multiple) segmentectomy. Resected parenchyma as described by total number of removed segments was 3.9 ± 1.6 segments. Preoperative FEV1 was 35.1 ± 7.2%, with an expected ppoFEV1 28.1 ± 5.9%. Measured postoperative FEV1 was 39 ± 8.7% (p < 0.001). Postoperative complications included persistent air leak (PAL) in 7 patients (43.8%), atelectasis in 3 (18.8%), pleural effusion in 4 (25%), pneumonia in 1 (6.3%), and empyema in one (6.3%), patients. No patient required continuous O2 therapy or died. Conclusions Even in severely impaired lung function, anatomical resection appears to be feasible with reasonable morbidity and mortality. |
| format | Article |
| id | doaj-art-88679aed8405460fb0acb159f09db752 |
| institution | Kabale University |
| issn | 2314-8551 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Bronchology |
| spelling | doaj-art-88679aed8405460fb0acb159f09db7522025-08-20T03:45:48ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-08-011911710.1186/s43168-025-00444-9Anatomical lung resection in patients with severely impaired pulmonary functionTomoyuki Nakagiri0Hayan Merhej1Akylbek Saipbaev2Alaa Selman3Heiko Golpon4Tobias Goecke5Arjang Ruhparwar6Patrick Zardo7Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolGerman Center for Lung Research (DZL)Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical SchoolAbstract Background Predicted postoperative forced expiratory volume in 1 s (ppoFEV1) and expected transfer factor for CO (TLCO) values < 30–35% are often considered to be a contraindication for anatomical lung resection in patients with lung cancer. Based on our prior positive experience in lung volume reduction surgery (LVRS), we retrospectively analyzed all patients with impaired pulmonary function undergoing anatomical minimally-invasive lung resection, either for LVRS or treatment of non-small cell lung cancer (NSCLC) at our institute. Methods From August 2016 to April 2021, n = 42 consecutive anatomical lung resections were performed in patients with poor lung function (< 35% ppoFEV1). We retrospectively searched our records and investigated the patients’ pre- and postoperative conditions and their outcome. Results We included 16 patients (9 males, age 68.4 ± 8.9 years old) scheduled for lung cancer surgery. The procedures were performed via uniportal video assisted thoracoscopic surgery (VATS; n = 10, 62.5%, including one non-intubated VATS) or via thoracotomy (n = 6, 37.5%) and included lobectomy (9 patients, 55.3%) or (multiple) segmentectomy. Resected parenchyma as described by total number of removed segments was 3.9 ± 1.6 segments. Preoperative FEV1 was 35.1 ± 7.2%, with an expected ppoFEV1 28.1 ± 5.9%. Measured postoperative FEV1 was 39 ± 8.7% (p < 0.001). Postoperative complications included persistent air leak (PAL) in 7 patients (43.8%), atelectasis in 3 (18.8%), pleural effusion in 4 (25%), pneumonia in 1 (6.3%), and empyema in one (6.3%), patients. No patient required continuous O2 therapy or died. Conclusions Even in severely impaired lung function, anatomical resection appears to be feasible with reasonable morbidity and mortality.https://doi.org/10.1186/s43168-025-00444-9Lung cancerObstructive impaired lung functionAnatomical lung resectionSurgical indication |
| spellingShingle | Tomoyuki Nakagiri Hayan Merhej Akylbek Saipbaev Alaa Selman Heiko Golpon Tobias Goecke Arjang Ruhparwar Patrick Zardo Anatomical lung resection in patients with severely impaired pulmonary function The Egyptian Journal of Bronchology Lung cancer Obstructive impaired lung function Anatomical lung resection Surgical indication |
| title | Anatomical lung resection in patients with severely impaired pulmonary function |
| title_full | Anatomical lung resection in patients with severely impaired pulmonary function |
| title_fullStr | Anatomical lung resection in patients with severely impaired pulmonary function |
| title_full_unstemmed | Anatomical lung resection in patients with severely impaired pulmonary function |
| title_short | Anatomical lung resection in patients with severely impaired pulmonary function |
| title_sort | anatomical lung resection in patients with severely impaired pulmonary function |
| topic | Lung cancer Obstructive impaired lung function Anatomical lung resection Surgical indication |
| url | https://doi.org/10.1186/s43168-025-00444-9 |
| work_keys_str_mv | AT tomoyukinakagiri anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT hayanmerhej anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT akylbeksaipbaev anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT alaaselman anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT heikogolpon anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT tobiasgoecke anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT arjangruhparwar anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction AT patrickzardo anatomicallungresectioninpatientswithseverelyimpairedpulmonaryfunction |