Impact of a Rescue Program on the Operability of Patients With Bronchogenic Carcinoma and Chronic Obstructive Pulmonary Disease

Sebastián, Guillem Gómez; Rous, Rosa Güell; Valencia, Araceli González; Alfara, Juan José Fibla; Saló, G. Estrada; González, Carlos

doi:10.1016/s1579-2129(07)60064-0

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…The addition of inhaled steroid to long acting bronchodilator in patients with previously untreated COPD has been found related with improved preoperative FEV1 and lower postoperative pulmonary complication rate compared to long acting bronchodilator alone (17). The association of respiratory physiotherapy before surgery has been also proven to provide significant functional improvement allowing the operation in patients previously considered unfit for the pulmonary resection (18).…”

Section: Comorbidities and Risk Factorsmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) and fast-track in video-assisted thoracic surgery (VATS) lobectomy: preoperative optimisation and care-plans

D’Andrilli

Rendina

2018

J. Vis. Surg.

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Main specific interventions for preoperative clinical optimisation of patients undergoing lung cancer surgery include assessment and treatment of comorbidities, minimizing preoperative hospitalization, minimizing preoperative fasting, and optimisation of antibiotic and thrombo-embolic prophylaxis. Preoperative patient optimisation is considered a crucial part of enhanced recovery after thoracic surgery pathways. Potentially, advantages of this fast-track management could be even higher when considering video-assisted thoracic surgery (VATS) major lung resection, because reduced trauma related to minimally invasive techniques is one of the main factors improving postoperative outcome. Literature data and clinical evidences in this setting are reported and discussed.

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Section: Comorbidities and Risk Factorsmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) and fast-track in video-assisted thoracic surgery (VATS) lobectomy: preoperative optimisation and care-plans

D’Andrilli

Rendina

2018

J. Vis. Surg.

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“… 9 , 10 So far, most LC studies regarding COPD have been focused on the early stages of the disease, trying to prevent complications and mortality related to surgery. 9 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Impact of COPD in patients with lung cancer and advanced disease treated with chemotherapy and/or tyrosine kinase inhibitors

Izquierdo¹,

Resano²,

Hachem³

et al. 2014

COPD

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While it is relatively well known that the prognosis of patients with lung cancer (LC) treated with surgery is worse in the presence of chronic obstructive pulmonary disease (COPD), it is unknown if this assessment can be extrapolated to patients with advanced disease treated with chemotherapy and/or tyrosine kinase inhibitors. The aim of our study is to analyze the clinical characteristics and survival rates in patients with LC and COPD, and to compare these to the patients without airflow obstruction. From 471 evaluable patients, 324 (69%) were not treated with surgery due to disseminated disease (stages 3B and 4). Of them, 47.7% also had COPD. All patients were treated at the moment of diagnosis according to National Comprehensive Cancer Network guidelines with platinum-based chemotherapy or tyrosine kinase inhibitors. Kaplan–Meier curves showed no significant differences in overall survival between COPD and non-COPD patients (log–rank P=0.65). In the multivariate Cox proportional hazard model adjusting for the most relevant variables, the adjusted hazard ratio (HRadj) was statistically significant for performance status (HRadj =1.33, 95% confidence interval [CI]: 1.11–1.59; P=0.002) and clinical stage (HRadj =0.67, 95% CI: 0.50–0.89; P=0.006), but not for COPD status (HRadj =1.20, 95% CI: 0.83–1.50; P=0.46). Our conclusion is that at present, when using standard care in advanced LC (stages 3B and 4), COPD does not have a significant deleterious impact on overall survival.

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“…In another prospective randomized study analyzing patients with untreated COPD, the addition of inhaled steroid to long acting bronchodilator was related with improved preoperative FEV1 and decreased postoperative pulmonary complication rate (18) compared to long acting bronchodilator alone. There is also evidence that pharmacological optimisation associated with respiratory physiotherapy in the preoperative setting may result in significant functional improvement allowing the operation in patients previously considered unfit for surgical resection (19). Based on current available data, optimisation of pharmacological therapy associated with respiratory physiotherapy should be recommended in functionally compromised patients with the aim of improving respiratory function and reducing perioperative morbidity.…”

Section: Patient Optimisation For Comorbidities and Risk Factorsmentioning

confidence: 99%

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: preoperative optimisation

2018

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Preoperative patient optimisation is a key point of enhanced recovery after thoracic surgery pathways. This could be particularly advantageous when considering video-assisted thoracic surgery (VATS) lobectomy, because reduced trauma related to minimally invasive techniques is one of the main factors favouring improved postoperative outcome. Main specific interventions for clinical optimisation before major lung resection include assessment and treatment of comorbidities, minimizing preoperative hospitalization, optimisation of pharmacological prophylaxis (antibiotic and thromboembolic) and minimizing preoperative fasting. Literature data and clinical evidences in this setting are reported and discussed.

show abstract

Impact of a Rescue Program on the Operability of Patients With Bronchogenic Carcinoma and Chronic Obstructive Pulmonary Disease

Cited by 8 publications

References 24 publications

Enhanced recovery after surgery (ERAS) and fast-track in video-assisted thoracic surgery (VATS) lobectomy: preoperative optimisation and care-plans

Enhanced recovery after surgery (ERAS) and fast-track in video-assisted thoracic surgery (VATS) lobectomy: preoperative optimisation and care-plans

Impact of COPD in patients with lung cancer and advanced disease treated with chemotherapy and/or tyrosine kinase inhibitors

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: preoperative optimisation

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