Author of

• 10643

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10671

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    P1.07-028 - Thoracoscopic minimally invasive surgery for non-small cell lung cancer in patients with chronic obstructive pulmonary disease (ID 2148)

    09:30 - 09:30  |  Author(s): F. Cui
    • Abstract

    Background
    To determine the incidence of peri-operative complications in non-small cell lung cancer (NSCLC) patients with co-existent chronic obstructive pulmonary disease (COPD) who undergo lung resection via traditional and minimally invasive techniques.

    Methods
    A retrospective analysis was conducted of 152 NSCLC patients with COPD who underwent thoracoscopic minimally invasive surgery. Particular attention is given to the relationship between disease severity or surgical approach and the incidence of complications.

    Results
    The prevalence of respiratory and cardiac complications was significantly higher in patients with severe/extremely severe COPD than those with mild to moderate COPD (respiratory compications: 37.3% vs. 20.4%, P=0.022; cardiac complictions: 16.9% vs. 6.5%, P=0.040). Patients who underwent complete-video assisted thoracoscopic surgery (c-VATS) had a significantly lower overall morbidity of adverse reactions than those who had undergone VATS major resection surgery (26.3% vs. 42.1%, P=0.044). Among patients with severe/extremely severe COPD, there was no significant difference in the incidence of any complication between the lobectomy group and wedge resection group (38.8% vs. 70.0%, P=0.072). Overall, the occurrence of adverse reactions was significantly lower in patients who underwent c-VATS than in those who had undergone VATS major resection surgery (34.2% vs. 61.9%, P=0.038).

    Conclusion
    VATS techniques are suitable for COPD patients and are demonstrated here to lower the incidence of post-operative complications when compared with more invasive approaches. Minimally invasive approaches should be considered in patients with COPD who are deemed high risk for curative surgery by traditional techniques.

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12515

    +

    P3.07-020 - Nonintubated Thoracoscopic Lobectomy for Lung Cancer: Experience of Two Medical Centers from Taiwan and China (ID 1783)

    09:30 - 09:30  |  Author(s): F. Cui
    • Abstract

    Background
    General anesthesia with single-lung ventilation is considered mandatory for thoracoscopic lobectomy for non-small cell lung cancer (NSCLC). Nonintubated thoracoscopic lobectomy has rarely been reported previously. The objective of this study was to evaluate the feasibility and safety of thoracoscopic lobectomy without endotracheal intubation.

    Methods
    From August 2009 through March 2013, 196 patients with clinical stage I or II NSCLC were treated by non-intubated thoracoscopic lobectomy using epidural anesthesia, intrathoracic vagal blockade, and sedation at National Taiwan University Hospital, Taiwan, and The First Affiliated Hospital of Guangzhou Medical College, China.

    Results
    The mean age of the patients were 59 years and 128 (65.3%) were female. Collapse of the operative lung and inhibition of coughing were satisfactory in the non-intubated patients, induced by spontaneous breathing and vagal blockade. Sixteen patients (8.2%) required conversion to intubated-single lung ventilation because of significant mediastinal movement, persistent hypoxemia, dense pleural adhesions, and bleeding. Two patients were converted to standard thoracotomy because of bleeding. The mean postoperative chest tube drainage and postoperative hospital stay were 3.6 days and 6.8 days, respectively. Postoperative complications were noted in 23 (11.7%) patients, including prolonged air leaks, arrhythmia, pneumonia, and bleeding. No operation mortalities were noted.

    Conclusion
    Non-intubated thoracoscopic lobectomy is technically feasible and safe. It can be a valid alternative of single-lung ventilated thoracoscopic lobectomy in managing selected patients with early-stage NSCLC.