Abstract

LAFFITA ZAMORA, Joan  and  FLEITES GONZALEZ, Gilberto. Lung cancer surgery in combination with volume-reducing surgery. Rev Cub Med Mil [online]. 2016, vol.45, n.1, pp.85-91. ISSN 0138-6557.

In thoracic surgery, assessing a patient with very severe chronic obstructive pulmonary disease is a challenge for the surgical team, since spirometric results may contraindicate the intervention. This case report describes the criteria used to define surgical interventions, the strategy assumed by the thorax group, the anesthetic management and subsequent evolution of the patient, who underwent lung volume reduction surgery, with an initial unilateral approach in the right upper lobe and final surgery a month later, with posterior left posterolateral thoracotomy to resect a Pancoast tumor. There was a decrease in dyspnea and a gradual increase in physical capacity after each surgical procedure. The forced expiratory volume in the first second in relation to the predicted values improved from 25 % to 38 % after surgery, and 41% six months later. Tiffeneau index varied from 0.43 to 0.57 and 0.60 after two thoracic surgeries. As a single complication, the patient presented chronic chest pain for which he maintains medical treatment. It is concluded that the performance of pulmonary volume reduction surgery is an alternative to gauge in patients with lung cancer and bullous pulmonary emphysema. The multidisciplinary perioperative approach is a fundamental pillar to achieve satisfactory results.

Keywords : thoracic surgery; Pancoast tumor; chronic obstructive pulmonary disease; pulmonary volume reduction surgery.

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