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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Bronchogenic carcinoma and chronic obstructive pulmonary disease &#40;COPD&#41; are strongly associated in our setting&#44; occurring together in around 70&#37; of cases&#46; Approximately 60&#37; of COPD patients who require resection for bronchogenic carcinoma are considered unfit for surgery because of seriously impaired lung function&#46; The purpose of this study was to evaluate the extent to which a rescue program could improve lung function in COPD patients who had previously been considered unfit for surgery because of poor lung function&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study enrolled COPD patients who had not been considered for surgical resection because they had a predicted postoperative forced expiratory volume in 1 second &#40;FEV<span class="elsevierStyleInf">1</span>&#41; of less than 1 L&#46; All of the patients participated in a 2-week rescue program that involved optimization of drug treatment &#40;inhaled bronchodilators and&#47;or corticosteroids&#41; and intensive respiratory physiotherapy&#46; Lung function was analyzed before and after the program&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">We evaluated 30 patients &#40;26 men and 4 women&#41; with a mean &#40;SD&#41; age of 66&#46;7 &#40;8&#46;15&#41; years and an initial FEV<span class="elsevierStyleInf">1</span> of 1&#46;497 &#40;0&#46;27&#41; mL &#40;FEV<span class="elsevierStyleInf">1</span> &#37; of 55&#46;7&#37; &#91;20&#46;14&#37;&#93;&#41;&#46; None of the patients had respiratory failure &#40;PaO<span class="elsevierStyleInf">2</span> of 77&#46;0 &#91;9&#46;4&#93; mm Hg and PaCO 2 of 41&#46;6 &#91;2&#46;4&#93; mm Hg&#41;&#46; Twenty-four patients &#40;80&#37;&#41; showed significant improvement in lung function &#40;P&#60;&#46;001&#41; after the program and were admitted for resection&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Two wedge resections&#44; 18 lobectomies&#44; 2 pneumonectomies&#44; and 2 exploratory thoracotomies were performed &#40;based on oncologic indications&#41;&#46; Nineteen of the 24 patients who underwent surgery had no complications&#46; Two patients had prolonged air leaks&#44; 1 empyema&#44; and 1 hemothorax&#46; One patient died from sepsis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">A large number &#40;80&#37;&#41; of COPD patients previously considered unfit for surgical resection because of seriously impaired lung function can be admitted for surgery following an intensive drug and respiratory physiotherapy rescue program&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La asociaci&#243;n entre carcinoma broncog&#233;nico y enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; se sit&#250;a en torno al 70&#37; en nuestro medio&#46; Aproximadamente un 60&#37; de los pacientes con dichos diagn&#243;sticos son rechazados para cirug&#237;a de resecci&#243;n del carcinoma broncog&#233;nico debi-do a la intensa alteraci&#243;n de su funci&#243;n pulmonar&#46; El objeti-vo del presente trabajo es evaluar el efecto de un programa de rescate en la mejor&#237;a de la funci&#243;n pulmonar de pacientes con EPOC y previamente descartados para cirug&#237;a por la alteraci&#243;n de su funci&#243;n pulmonar&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en el estudio a pacientes con EPOC descartados inicialmente porque se hab&#237;a calcu-lado que su volumen espiratorio forzado en el primer segun-do &#40;FEV<span class="elsevierStyleInf">1</span>&#41; tras la intervenci&#243;n quir&#250;rgica ser&#237;a menor de 1 l&#46; Todos ellos participaron en un programa de rescate de 2 se-manas de duraci&#243;n que inclu&#237;a&#58; optimizaci&#243;n del tratamien-to farmacol&#243;gico &#40;broncodilatadores inhalados y&#47;o corticoi-des&#41; y fisioterapia respiratoria intensiva&#46; Se analiz&#243; la funci&#243;n pulmonar antes y despu&#233;s del programa&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se evalu&#243; a 30 pacientes &#40;26 varones y 4 muje-res&#41; con una edad media &#177; desviaci&#243;n est&#225;ndar de 66&#44;7 &#177; 8&#44;15 a&#241;os y FEV<span class="elsevierStyleInf">1</span> inicial de 1&#44;497 &#177; 0&#44;27 ml &#40;FEV<span class="elsevierStyleInf">1</span> &#37;&#58; 55&#44;7 &#177; 20&#44;14 l&#41;&#44; que no presentaban insuficiencia respiratoria &#40;presi&#243;n ar-terial de ox&#237;geno&#58; 77&#44;0 &#177; 9&#44;4 mmHg&#59; presi&#243;n arterial de an-h&#237;drido carb&#243;nico&#58; 41&#44;6 &#177; 2&#44;4 mmHg&#41;&#46; Tras el programa 24 pacientes &#40;80&#37;&#41; pudieron ser aceptados para la resecci&#243;n propuesta al objetivarse una mejor&#237;a significativa en la fun-ci&#243;n pulmonar &#40;p &#60; 0&#44;001&#41;&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Se realizaron 2 resecciones en cu&#241;a&#44; 18 lobectom&#237;as&#44; 2 neumonectom&#237;as y 2 toracotom&#237;as exploradoras &#40;por crite-rios oncol&#243;gicos&#41;&#46; De los 24 pacientes a los que se intervino&#44; en 19 no hubo complicaciones&#44; 2 presentaron fugas a&#233;reas mantenidas&#44; hubo un caso de empiema pleural y otro de he-mot&#243;rax&#46; Un paciente falleci&#243; por sepsis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El dise&#241;o de un programa intensivo far-macol&#243;gico y de fisioterapia respiratoria permite rescatar para cirug&#237;a a un n&#250;mero alto &#40;80&#37;&#41; de los pacientes con EPOC a los que inicialmente se descarta por una alteraci&#243;n importante de la funci&#243;n pulmonar&#46;</p>"
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Original Articles
Impact of a Rescue Program on the Operability of Patients With Bronchogenic Carcinoma and Chronic Obstructive Pulmonary Disease
Guillem Gómez Sebastiána,
Corresponding author
ggomezs@hsp.santpau.es

Correspondence: Dr. G. Gómez Sebastián. Servicio de Cirugía Torácica. Hospital de la Santa Creu i Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
, Rosa Güell Rousb,c, Araceli González Valenciab, Juan José Fibla Alfaraa, Gaspar Estrada Salóa, Carlos León Gonzáleza
a Servicio de Cirugía Torácica, Hospital de la Santa Creu i Sant Pau, Facultat de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
b Departamento de Neumología, Hospital de la Santa Creu i Sant Pau, Facultat de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
c RTIC-ISCIII-Red Respira, Hospital de la Santa Creu i Sant Pau, Facultat de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Bronchogenic carcinoma and chronic obstructive pulmonary disease &#40;COPD&#41; are strongly associated in our setting&#44; occurring together in around 70&#37; of cases&#46; Approximately 60&#37; of COPD patients who require resection for bronchogenic carcinoma are considered unfit for surgery because of seriously impaired lung function&#46; The purpose of this study was to evaluate the extent to which a rescue program could improve lung function in COPD patients who had previously been considered unfit for surgery because of poor lung function&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study enrolled COPD patients who had not been considered for surgical resection because they had a predicted postoperative forced expiratory volume in 1 second &#40;FEV<span class="elsevierStyleInf">1</span>&#41; of less than 1 L&#46; All of the patients participated in a 2-week rescue program that involved optimization of drug treatment &#40;inhaled bronchodilators and&#47;or corticosteroids&#41; and intensive respiratory physiotherapy&#46; Lung function was analyzed before and after the program&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">We evaluated 30 patients &#40;26 men and 4 women&#41; with a mean &#40;SD&#41; age of 66&#46;7 &#40;8&#46;15&#41; years and an initial FEV<span class="elsevierStyleInf">1</span> of 1&#46;497 &#40;0&#46;27&#41; mL &#40;FEV<span class="elsevierStyleInf">1</span> &#37; of 55&#46;7&#37; &#91;20&#46;14&#37;&#93;&#41;&#46; None of the patients had respiratory failure &#40;PaO<span class="elsevierStyleInf">2</span> of 77&#46;0 &#91;9&#46;4&#93; mm Hg and PaCO 2 of 41&#46;6 &#91;2&#46;4&#93; mm Hg&#41;&#46; Twenty-four patients &#40;80&#37;&#41; showed significant improvement in lung function &#40;P&#60;&#46;001&#41; after the program and were admitted for resection&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Two wedge resections&#44; 18 lobectomies&#44; 2 pneumonectomies&#44; and 2 exploratory thoracotomies were performed &#40;based on oncologic indications&#41;&#46; Nineteen of the 24 patients who underwent surgery had no complications&#46; Two patients had prolonged air leaks&#44; 1 empyema&#44; and 1 hemothorax&#46; One patient died from sepsis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">A large number &#40;80&#37;&#41; of COPD patients previously considered unfit for surgical resection because of seriously impaired lung function can be admitted for surgery following an intensive drug and respiratory physiotherapy rescue program&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La asociaci&#243;n entre carcinoma broncog&#233;nico y enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; se sit&#250;a en torno al 70&#37; en nuestro medio&#46; Aproximadamente un 60&#37; de los pacientes con dichos diagn&#243;sticos son rechazados para cirug&#237;a de resecci&#243;n del carcinoma broncog&#233;nico debi-do a la intensa alteraci&#243;n de su funci&#243;n pulmonar&#46; El objeti-vo del presente trabajo es evaluar el efecto de un programa de rescate en la mejor&#237;a de la funci&#243;n pulmonar de pacientes con EPOC y previamente descartados para cirug&#237;a por la alteraci&#243;n de su funci&#243;n pulmonar&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en el estudio a pacientes con EPOC descartados inicialmente porque se hab&#237;a calcu-lado que su volumen espiratorio forzado en el primer segun-do &#40;FEV<span class="elsevierStyleInf">1</span>&#41; tras la intervenci&#243;n quir&#250;rgica ser&#237;a menor de 1 l&#46; Todos ellos participaron en un programa de rescate de 2 se-manas de duraci&#243;n que inclu&#237;a&#58; optimizaci&#243;n del tratamien-to farmacol&#243;gico &#40;broncodilatadores inhalados y&#47;o corticoi-des&#41; y fisioterapia respiratoria intensiva&#46; Se analiz&#243; la funci&#243;n pulmonar antes y despu&#233;s del programa&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se evalu&#243; a 30 pacientes &#40;26 varones y 4 muje-res&#41; con una edad media &#177; desviaci&#243;n est&#225;ndar de 66&#44;7 &#177; 8&#44;15 a&#241;os y FEV<span class="elsevierStyleInf">1</span> inicial de 1&#44;497 &#177; 0&#44;27 ml &#40;FEV<span class="elsevierStyleInf">1</span> &#37;&#58; 55&#44;7 &#177; 20&#44;14 l&#41;&#44; que no presentaban insuficiencia respiratoria &#40;presi&#243;n ar-terial de ox&#237;geno&#58; 77&#44;0 &#177; 9&#44;4 mmHg&#59; presi&#243;n arterial de an-h&#237;drido carb&#243;nico&#58; 41&#44;6 &#177; 2&#44;4 mmHg&#41;&#46; Tras el programa 24 pacientes &#40;80&#37;&#41; pudieron ser aceptados para la resecci&#243;n propuesta al objetivarse una mejor&#237;a significativa en la fun-ci&#243;n pulmonar &#40;p &#60; 0&#44;001&#41;&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Se realizaron 2 resecciones en cu&#241;a&#44; 18 lobectom&#237;as&#44; 2 neumonectom&#237;as y 2 toracotom&#237;as exploradoras &#40;por crite-rios oncol&#243;gicos&#41;&#46; De los 24 pacientes a los que se intervino&#44; en 19 no hubo complicaciones&#44; 2 presentaron fugas a&#233;reas mantenidas&#44; hubo un caso de empiema pleural y otro de he-mot&#243;rax&#46; Un paciente falleci&#243; por sepsis&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El dise&#241;o de un programa intensivo far-macol&#243;gico y de fisioterapia respiratoria permite rescatar para cirug&#237;a a un n&#250;mero alto &#40;80&#37;&#41; de los pacientes con EPOC a los que inicialmente se descarta por una alteraci&#243;n importante de la funci&#243;n pulmonar&#46;</p>"
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Article information
ISSN: 15792129
Original language: English
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2014 November 19 8 27
2014 October 24 10 34
2014 September 26 8 34
2014 August 28 5 33
2014 July 27 3 30
2014 June 42 9 51
2014 May 47 10 57
2014 April 42 5 47
2014 March 40 7 47
2014 February 61 8 69
2014 January 32 7 39
2013 December 41 7 48
2013 November 21 3 24
2013 October 41 6 47
2013 September 27 9 36
2013 August 31 4 35
2013 July 46 12 58
2013 June 31 8 39
2013 May 37 8 45
2013 April 20 7 27
2013 March 7 2 9
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Archivos de Bronconeumología

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