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Article: Lung Volume Reduction Surgery Allows Esophageal Tumor Resection in Selected Esophageal Carcinoma With Severe Emphysema

TitleLung Volume Reduction Surgery Allows Esophageal Tumor Resection in Selected Esophageal Carcinoma With Severe Emphysema
Authors
Issue Date2006
Citation
Annals of Thoracic Surgery, 2006, v. 82 n. 5, p. 1849-1856 How to Cite?
AbstractBackground: Esophageal carcinoma patients with coexisting severe emphysema are high risk surgical candidates. We hypothesize that simultaneous unilateral lung volume reduction surgery (LVRS) allows us to offer esophageal tumor resection to patients previously considered inoperable. Methods: Twenty-one patients with esophageal carcinoma were recruited. All patients had severe emphysema with impaired respiratory function and health-related quality of life (HRQL). Esophageal tumor resection with gastroesophagostomy in the thorax and then unilateral LVRS were performed at the same anesthesia. Dyspnea index, exercise capacity, pulmonary function, and HRQL were assessed at baseline and every three months up to one year postoperatively. Results: There was no perioperative death or significant morbidity. Clinical improvements were observed at 3, 6, and 12 months, in terms of dyspnea index, forced expiratory volume in 1 second, residual volume, partial pressure of oxygen, arterial, partial pressure of carbon dioxide, arterial, 6-minute walking distance, dysphagia, and odynophagia (p < 0.01 or p < 0.05). The Karnofsky Performance Status score improved from baseline 36 ± 3 to 53 ± 3 at 3 months, 67 ± 5 at 6 months, and 63 ± 8 at 12 months (p < 0.01). Significant improvement was seen in all the Short-Form 36-item Health Survey HRQL domains at 3 months (p < 0.01 or p < 0.05). These improvements remained significant for up to 6 months, and for up to 12 months for physical functioning and general health. The Psychosocial Adjustment to Illness Scale score and all the scales were improved after surgery (p < 0.01). Conclusions: Our study shows that in selected patients with esophageal carcinoma who suffer from severe emphysema, simultaneous unilateral LVRS renders esophageal tumor resection safe and effective. Also, these patients may experience early improvement in pulmonary function and HRQL. © 2006 The Society of Thoracic Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/192662
ISSN
2015 Impact Factor: 2.975
2015 SCImago Journal Rankings: 1.490
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTan, Q-Yen_US
dc.contributor.authorWang, R-Wen_US
dc.contributor.authorJiang, Y-Gen_US
dc.contributor.authorFan, S-Zen_US
dc.contributor.authorHsin, MKYen_US
dc.contributor.authorGong, T-Qen_US
dc.contributor.authorZhou, J-Hen_US
dc.contributor.authorZhao, Y-Pen_US
dc.date.accessioned2013-11-20T04:54:58Z-
dc.date.available2013-11-20T04:54:58Z-
dc.date.issued2006en_US
dc.identifier.citationAnnals of Thoracic Surgery, 2006, v. 82 n. 5, p. 1849-1856en_US
dc.identifier.issn0003-4975en_US
dc.identifier.urihttp://hdl.handle.net/10722/192662-
dc.description.abstractBackground: Esophageal carcinoma patients with coexisting severe emphysema are high risk surgical candidates. We hypothesize that simultaneous unilateral lung volume reduction surgery (LVRS) allows us to offer esophageal tumor resection to patients previously considered inoperable. Methods: Twenty-one patients with esophageal carcinoma were recruited. All patients had severe emphysema with impaired respiratory function and health-related quality of life (HRQL). Esophageal tumor resection with gastroesophagostomy in the thorax and then unilateral LVRS were performed at the same anesthesia. Dyspnea index, exercise capacity, pulmonary function, and HRQL were assessed at baseline and every three months up to one year postoperatively. Results: There was no perioperative death or significant morbidity. Clinical improvements were observed at 3, 6, and 12 months, in terms of dyspnea index, forced expiratory volume in 1 second, residual volume, partial pressure of oxygen, arterial, partial pressure of carbon dioxide, arterial, 6-minute walking distance, dysphagia, and odynophagia (p < 0.01 or p < 0.05). The Karnofsky Performance Status score improved from baseline 36 ± 3 to 53 ± 3 at 3 months, 67 ± 5 at 6 months, and 63 ± 8 at 12 months (p < 0.01). Significant improvement was seen in all the Short-Form 36-item Health Survey HRQL domains at 3 months (p < 0.01 or p < 0.05). These improvements remained significant for up to 6 months, and for up to 12 months for physical functioning and general health. The Psychosocial Adjustment to Illness Scale score and all the scales were improved after surgery (p < 0.01). Conclusions: Our study shows that in selected patients with esophageal carcinoma who suffer from severe emphysema, simultaneous unilateral LVRS renders esophageal tumor resection safe and effective. Also, these patients may experience early improvement in pulmonary function and HRQL. © 2006 The Society of Thoracic Surgeons.en_US
dc.languageengen_US
dc.relation.ispartofAnnals of Thoracic Surgeryen_US
dc.titleLung Volume Reduction Surgery Allows Esophageal Tumor Resection in Selected Esophageal Carcinoma With Severe Emphysemaen_US
dc.typeArticleen_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.athoracsur.2006.05.081en_US
dc.identifier.pmid17062259-
dc.identifier.scopuseid_2-s2.0-33750082369en_US
dc.identifier.volume82en_US
dc.identifier.issue5en_US
dc.identifier.spage1849en_US
dc.identifier.epage1856en_US
dc.identifier.isiWOS:000241497600042-

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