Concomitant lung cancer resection and lung volume reduction surgery.

Patients who are offered concomitant surgery are highly selected and must satisfy the strict criteria set out for both LVRS and cancer surgery. Several evaluative processes have been reported for the selection of suitable patients. These various evaluative processes, together with the physical condition of the patient and the surgeon's experience, help to best select patients suitable for combined surgical resection. Several intraoperative strategies are available for dealing with a patient who has concomitant lung cancer and severe emphysema. The choice of technique depends on the location and size of the tumor, the severity and distribution of the emphysema, and the surgeon's experience and preference. Lung volume reduction surgery in well-selected patients who have severe emphysema results in postoperative improvement of symptoms and measured pulmonary function. The combination of lung cancer resection with LVRS offers selected patients who have concomitant early lung cancer and severe emphysema the opportunity to undergo resection of their cancer with improvement rather than further reduction in their pulmonary function. By traditional criteria these patients would otherwise be considered unsuitable surgical candidates because of the limited pulmonary function.