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
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"idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212907600639?idApp=UINPBA00003Z" "url" => "/15792129/0000004300000005/v1_201305150317/S1579212907600639/v1_201305150317/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Impact of a Rescue Program on the Operability of Patients With Bronchogenic Carcinoma and Chronic Obstructive Pulmonary Disease" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "262" "paginaFinal" => "266" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Guillem Gómez Sebastián, Rosa Güell Rous, Araceli González Valencia, Juan José Fibla Alfara, Gaspar Estrada Saló, Carlos León González" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Guillem Gómez" "apellidos" => "Sebastián" "email" => array:1 [ 0 => "ggomezs@hsp.santpau.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Rosa Güell" "apellidos" => "Rous" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 2 => array:3 [ "nombre" => "Araceli González" "apellidos" => "Valencia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "Juan José Fibla" "apellidos" => "Alfara" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "Gaspar Estrada" "apellidos" => "Saló" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "Carlos León" "apellidos" => "González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital de la Santa Creu i Sant Pau, Facultat de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departamento de Neumología, Hospital de la Santa Creu i Sant Pau, Facultat de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "RTIC-ISCIII-Red Respira, Hospital de la Santa Creu i Sant Pau, Facultat de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "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" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-02-24" "fechaAceptado" => "2006-11-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154864" "palabras" => array:4 [ 0 => "Bronchogenic carcinoma" 1 => "COPD" 2 => "Surgical resection" 3 => "Respiratory physiotherapy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154865" "palabras" => array:4 [ 0 => "Carcinoma broncogénico" 1 => "EPOC" 2 => "Cirugía de re-sección" 3 => "Fisioterapia respiratoria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Bronchogenic carcinoma and chronic obstructive pulmonary disease (COPD) are strongly associated in our setting, occurring together in around 70% of cases. Approximately 60% of COPD patients who require resection for bronchogenic carcinoma are considered unfit for surgery because of seriously impaired lung function. 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.</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 (FEV<span class="elsevierStyleInf">1</span>) of less than 1 L. All of the patients participated in a 2-week rescue program that involved optimization of drug treatment (inhaled bronchodilators and/or corticosteroids) and intensive respiratory physiotherapy. Lung function was analyzed before and after the program.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">We evaluated 30 patients (26 men and 4 women) with a mean (SD) age of 66.7 (8.15) years and an initial FEV<span class="elsevierStyleInf">1</span> of 1.497 (0.27) mL (FEV<span class="elsevierStyleInf">1</span> % of 55.7% [20.14%]). None of the patients had respiratory failure (PaO<span class="elsevierStyleInf">2</span> of 77.0 [9.4] mm Hg and PaCO 2 of 41.6 [2.4] mm Hg). Twenty-four patients (80%) showed significant improvement in lung function (P<.001) after the program and were admitted for resection.</p><p class="elsevierStyleSimplePara elsevierViewall">Two wedge resections, 18 lobectomies, 2 pneumonectomies, and 2 exploratory thoracotomies were performed (based on oncologic indications). Nineteen of the 24 patients who underwent surgery had no complications. Two patients had prolonged air leaks, 1 empyema, and 1 hemothorax. One patient died from sepsis.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">A large number (80%) 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.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La asociación entre carcinoma broncogénico y enfermedad pulmonar obstructiva crónica (EPOC) se sitúa en torno al 70% en nuestro medio. Aproximadamente un 60% de los pacientes con dichos diagnósticos son rechazados para cirugía de resección del carcinoma broncogénico debi-do a la intensa alteración de su función pulmonar. El objeti-vo del presente trabajo es evaluar el efecto de un programa de rescate en la mejoría de la función pulmonar de pacientes con EPOC y previamente descartados para cirugía por la alteración de su función pulmonar.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se incluyó en el estudio a pacientes con EPOC descartados inicialmente porque se había calcu-lado que su volumen espiratorio forzado en el primer segun-do (FEV<span class="elsevierStyleInf">1</span>) tras la intervención quirúrgica sería menor de 1 l. Todos ellos participaron en un programa de rescate de 2 se-manas de duración que incluía: optimización del tratamien-to farmacológico (broncodilatadores inhalados y/o corticoi-des) y fisioterapia respiratoria intensiva. Se analizó la función pulmonar antes y después del programa.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se evaluó a 30 pacientes (26 varones y 4 muje-res) con una edad media ± desviación estándar de 66,7 ± 8,15 años y FEV<span class="elsevierStyleInf">1</span> inicial de 1,497 ± 0,27 ml (FEV<span class="elsevierStyleInf">1</span> %: 55,7 ± 20,14 l), que no presentaban insuficiencia respiratoria (presión ar-terial de oxígeno: 77,0 ± 9,4 mmHg; presión arterial de an-hídrido carbónico: 41,6 ± 2,4 mmHg). Tras el programa 24 pacientes (80%) pudieron ser aceptados para la resección propuesta al objetivarse una mejoría significativa en la fun-ción pulmonar (p < 0,001).</p><p class="elsevierStyleSimplePara elsevierViewall">Se realizaron 2 resecciones en cuña, 18 lobectomías, 2 neumonectomías y 2 toracotomías exploradoras (por crite-rios oncológicos). De los 24 pacientes a los que se intervino, en 19 no hubo complicaciones, 2 presentaron fugas aéreas mantenidas, hubo un caso de empiema pleural y otro de he-motórax. Un paciente falleció por sepsis.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El diseño de un programa intensivo far-macológico y de fisioterapia respiratoria permite rescatar para cirugía a un número alto (80%) de los pacientes con EPOC a los que inicialmente se descarta por una alteración importante de la función pulmonar.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measuring cancer prevalence in Europe: the EUROPREVAL project" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "EUROPREVAL Working Group" "etal" => true "autores" => array:6 [ 0 => "R Capocaccia" 1 => "M Colonna" 2 => "I Corazziari" 3 => "R de Angelis" 4 => "S Francisci" 5 => "A Micheli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2002" "volumen" => "13" "paginaInicial" => "815" "paginaFinal" => "861" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12123326" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Criteria of functional and oncological operability in surgery for lung cancer: a multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A López-Encuentra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lung Cancer" "fecha" => "1998" "volumen" => "20" "paginaInicial" => "161" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9733050" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preoperative evaluation of the patient with pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "PE Epstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "paginaInicial" => "1695" "paginaFinal" => "1700" "serieVolumen" => "Vol. 2" "serieTitulo" => "Fishman's pulmonary diseases and disorders" "serieFecha" => "1980" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery (GCCBS). 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Year/Month | Html | Total | |
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2024 November | 4 | 6 | 10 |
2024 October | 30 | 24 | 54 |
2024 September | 29 | 25 | 54 |
2024 August | 44 | 42 | 86 |
2024 July | 23 | 26 | 49 |
2024 June | 27 | 18 | 45 |
2024 May | 29 | 25 | 54 |
2024 April | 15 | 28 | 43 |
2024 March | 18 | 13 | 31 |
2024 February | 18 | 28 | 46 |
2023 March | 2 | 3 | 5 |
2023 February | 15 | 23 | 38 |
2023 January | 17 | 25 | 42 |
2022 December | 17 | 20 | 37 |
2022 November | 21 | 24 | 45 |
2022 October | 20 | 27 | 47 |
2022 September | 13 | 17 | 30 |
2022 August | 15 | 33 | 48 |
2022 July | 18 | 43 | 61 |
2022 June | 14 | 21 | 35 |
2022 May | 14 | 28 | 42 |
2022 April | 18 | 31 | 49 |
2022 March | 14 | 30 | 44 |
2022 February | 16 | 29 | 45 |
2022 January | 14 | 36 | 50 |
2021 December | 11 | 38 | 49 |
2021 November | 17 | 41 | 58 |
2021 October | 53 | 45 | 98 |
2021 September | 26 | 55 | 81 |
2021 August | 12 | 30 | 42 |
2021 July | 7 | 20 | 27 |
2021 June | 11 | 19 | 30 |
2021 May | 9 | 21 | 30 |
2021 April | 13 | 28 | 41 |
2021 March | 11 | 13 | 24 |
2021 February | 22 | 13 | 35 |
2021 January | 9 | 11 | 20 |
2020 December | 10 | 7 | 17 |
2020 November | 8 | 10 | 18 |
2020 October | 4 | 8 | 12 |
2020 September | 39 | 1 | 40 |
2020 August | 68 | 10 | 78 |
2020 July | 29 | 11 | 40 |
2020 June | 10 | 3 | 13 |
2020 May | 27 | 9 | 36 |
2020 April | 33 | 20 | 53 |
2020 March | 32 | 10 | 42 |
2020 February | 65 | 12 | 77 |
2020 January | 42 | 11 | 53 |
2019 December | 20 | 18 | 38 |
2019 November | 8 | 8 | 16 |
2019 October | 10 | 6 | 16 |
2019 September | 42 | 24 | 66 |
2019 August | 25 | 11 | 36 |
2019 July | 9 | 17 | 26 |
2019 June | 3 | 11 | 14 |
2019 May | 9 | 19 | 28 |
2019 April | 15 | 26 | 41 |
2019 March | 13 | 17 | 30 |
2019 February | 5 | 12 | 17 |
2019 January | 9 | 2 | 11 |
2018 December | 5 | 16 | 21 |
2018 November | 9 | 5 | 14 |
2018 October | 19 | 12 | 31 |
2018 September | 14 | 9 | 23 |
2018 May | 4 | 0 | 4 |
2018 April | 4 | 6 | 10 |
2018 March | 4 | 4 | 8 |
2018 February | 5 | 8 | 13 |
2018 January | 1 | 8 | 9 |
2017 December | 4 | 3 | 7 |
2017 November | 8 | 3 | 11 |
2017 October | 8 | 10 | 18 |
2017 September | 5 | 3 | 8 |
2017 August | 8 | 10 | 18 |
2017 July | 6 | 6 | 12 |
2017 June | 7 | 23 | 30 |
2017 May | 5 | 6 | 11 |
2017 April | 2 | 4 | 6 |
2017 March | 3 | 15 | 18 |
2017 January | 3 | 4 | 7 |
2016 December | 7 | 4 | 11 |
2016 November | 12 | 8 | 20 |
2016 October | 5 | 6 | 11 |
2016 September | 6 | 8 | 14 |
2016 August | 4 | 1 | 5 |
2016 July | 6 | 3 | 9 |
2016 March | 2 | 0 | 2 |
2015 December | 2 | 0 | 2 |
2015 October | 37 | 13 | 50 |
2015 September | 50 | 9 | 59 |
2015 August | 23 | 9 | 32 |
2015 July | 30 | 5 | 35 |
2015 June | 32 | 11 | 43 |
2015 May | 43 | 17 | 60 |
2015 April | 36 | 16 | 52 |
2015 March | 26 | 4 | 30 |
2015 February | 40 | 4 | 44 |
2015 January | 20 | 5 | 25 |
2014 December | 25 | 5 | 30 |
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 |