Featured Research

from universities, journals, and other organizations

UPenn Surgery For Cancer-Ridden Lungs

Date:
September 15, 2000
Source:
University Of Pennsylvania Medical Center
Summary:
When a surgeon opens the chest of a lung cancer patient and finds that the malignancy has spread from one of the lungs to its pulmonary artery, he or she will almost always remove the entire lung. But doctors at the University of Pennsylvania Medical Center are performing and teaching a surgical procedure that routinely saves part of the affected lung, leaving the patient with more stamina, the potential for normal activity, and the same long-term prognisis.

Penn surgeons perform -- and teach -- a once-rare procedure: saving clear portions of cancer-ridden lungs when even a main pulmonary artery is involved in malignancy

Procedure has lower risk and leaves patients with more stamina than complete removal of the lung

When a surgeon opens the chest of a lung cancer patient and finds that the malignancy has spread from one of the lungs to its pulmonary artery, he or she will almost always remove the entire lung.

But doctors at the University of Pennsylvania Medical Center are performing and teaching a surgical procedure that routinely saves part of the affected lung, leaving the patient with more stamina, the potential for normal activity, and the same long-term prognisis.

In fact, when a lung is removed in its entirety, "there is a much greater risk of death after surgery, and certainly more shortness of breath permanently," according to Joseph B. Shrager, MD, PhD, a thoracic surgeon and assistant professor of surgery at the University of Pennsylvania Medical School.

Even though there has been scattered anecdotal evidence (and one other large published study) since the late 1960s that indicate the advantages of the lung-sparing procedure, which is described in medical terminology as a "lobectomy with tangential pulmonary artery resection," very few doctors have been willing to attempt it.

"Ninety-five percent of surgeons who operate for lung cancer are not comfortable with the procedure," said Shrager. "They're afraid of bleeding, and they feel it's too great a technical risk."

But since 1992, Penn's thoracic surgeons, led by Dr. Larry Kaiser, have successfully performed about 40 of the surgeries. They've found, according to Shrager, that "in most cases the procedure is only slightly more difficult than removing the entire lung."

A report of the team's findings based on the first 33 cases was published this summer in the Annals of Thoracic Surgery, and earlier this year, Shrager presented the results of those cases at the meeting of the Society of Thoracic Surgeons in Fort Lauderdale, Fla.

Decision-making in the operating room

In lung cancer, it can take from six months to two years before a malignant tumor is detected. Surgery is a viable treatment only in cases where a non-small-cell malignancy has not yet spread from the lung to the brain, bones, liver or adrenal glands. (Small cell carcinomas are most commonly treated with only radiation and chemotherapy.)

But when surgery is the clear course, even using the most sophisticated medical technology, a doctor still often cannot be sure before opening a patient's chest whether there is involvement of the pulmonary artery.

"We'll tell people, 'We take out only as much as we need to,'" Shrager said.

And so the final choice between a traditional pneumonectomy - the complete removal of the affected lung -- or an attempt to save part of the lung, is one that must be made on the floor of the operating room.

The delicate work of arterial resection

The most daunting part of the combined lobectomy/resection procedure is the pulmonary artery resection: The wall of the artery that is overgrown with malignancy is removed, and then the artery is stitched back together.

But the thoracic surgeons at Penn have found the surgery only slightly more challenging than traditional lung cancer surgery.

"Typically when we're doing the procedure it's a left upper lobe cancer and the tumor is growing into the pulmonary artery," Shrager said. "As long as it's not extensively growing into the artery, basically we clamp the pulmonary artery above and below where the tumor is invading, and then cut out only the side wall of the artery where the tumor is attached, causing a tangential incision, and then repair the artery."

"This is something that can easily be taught," Shrager said. "And it's something we hope to see become a standard procedure, whenever possible. The value of the technique is that patients who undergo this surgery appear to have the same chance of being cured of the cancer as those undergoing complete lung removal, but they will not experience any diminishment in the quality of their life."


Story Source:

The above story is based on materials provided by University Of Pennsylvania Medical Center. Note: Materials may be edited for content and length.


Cite This Page:

University Of Pennsylvania Medical Center. "UPenn Surgery For Cancer-Ridden Lungs." ScienceDaily. ScienceDaily, 15 September 2000. <www.sciencedaily.com/releases/2000/09/000913204503.htm>.
University Of Pennsylvania Medical Center. (2000, September 15). UPenn Surgery For Cancer-Ridden Lungs. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2000/09/000913204503.htm
University Of Pennsylvania Medical Center. "UPenn Surgery For Cancer-Ridden Lungs." ScienceDaily. www.sciencedaily.com/releases/2000/09/000913204503.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins