[The role of the nurse in lung cancer surgery]. / Le rôle infirmier dans la chirurgie du cancer du poumon.

The surgical period of the treatment of lung cancer is gruelling for the patient. Close to the patient from the pre-operative care onwards, nursing teams take turns in listening and providing technical care through to the patient's discharge. The optimal treatment of pain favours the early rehabilitation of the patient.

Cardiopulmonary function at rest and during exercise after resection for bronchial carcinoma.

BACKGROUND: Measurements of postoperative spirometric values after pneumonectomy and lobectomy vary considerably, and few researchers have studied the changes in exercise capacity during maximal work after lung resection. The purpose of this study was to describe the postoperative alterations in cardiopulmonary function. METHODS: Ninety-seven consecutive patients with lung malignancy were prospectively examined with maximal exercise test, spirometry, and arterial gas tensions. Fifty-seven patients were reinvestigated 6 months postoperatively. RESULTS: In patients having lobectomy, forced expiratory volume in 1 second decreased 8%, and exercise capacity, expressed by maximal oxygen uptake and maximal work rate, significantly decreased 13%. In patients having pneumonectomy forced expiratory volume in 1 second significantly decreased 23%, but the loss in lung volume was partly compensated as measured by exercise capacity, which decreased only 16%. Generally patients with the smallest preoperative forced vital capacity had the smallest postoperative deterioration expressed in percentages. We found a weak correlation between alterations in maximal oxygen uptake and lung function after resection. CONCLUSIONS: Lobectomy is associated with only minor deterioration of lung function and exercise capacity. Pneumonectomy causes a decrease in pulmonary volumes to about 75% of the preoperative values, partly compensated in better oxygen uptake, which postoperatively was about 85% of the preoperative values. Alteration in forced expiratory volume in 1 second is a poor predictor of change in exercise capacity after pulmonary resection.

[Rehabilitation of patients with respiratory problems--bronchogenic carcinoma]. / Rehabilitacija pacijenata sa pulmoloskom problematikom--bronhogeni karcinom.

Rehabilitation of the patients suffering from the pulmonologic problems with the bronchogenic cancer under our circumstances has not, practically, been established. There are neither physiotherapy nor kinesiology methods in rehabilitation. It would be necessary to appoint a team, consisting of: pulmonologist, physiatrist, physiotherapist and nurses with the consultation of the service corresponding the needs of the bronchogenic carcinoma problems. Basic breathing exercises principles, prior and post operative ones, kinesiotherapy and posture drainage techniques were presented in the paper.

[Respiratory care for pulmonary resection in geriatric patients with bronchogenic carcinoma].

In patients aged over 70 years with bronchogenic carcinoma, respiratory failure following pulmonary resection is the most common cause of death. Before August 1982, 23 patients over 70 were treated surgically at the National Defense Medical College Hospital. Of these 23 patients, 4 died from postoperative respiratory failure, 2 of them dying within 30 postoperative days. Since August 1982, 35 pulmonary resections have been performed in patients over 70 who have been managed with pulmonary rehabilitation, resulting in no deaths from respiratory failure. Pulmonary rehabilitation has also provided a shorter duration of atelectasis and a reduced need for bronchoscopic aspiration. We therefore consider that pulmonary rehabilitation is the respiratory care of choice in elderly patients undergoing pulmonary resection.

[Functional and oncologic results after bronchial or blood vessel anastomosis in the resection therapy of bronchogenic carcinoma]. / Funktionelle und karzinologische Resultate nach Bronchus- oder Gefässanastomosen in der Resektionsbehandlung von Bronchialkarzinomen.

In treatment of bronchogenic carcinoma twelve selected patients had economical resections. To avoid a pneumonectomy, lobectomies or bilobectomies were associated twice with bronchial excision, 8 times with bronchial resection (sleeve resection) and twice with resection and anastomosis of pulmonary artery. Nine patients underwent clinical, radiologic and szintigraphic control. Except one case all patients showed good functional results. The anastomosed lobes were perfused and ventilated proportionally to the number of segments. The quality of life after partial pulmonary resections had deteriorated only to a small extent compared with the preoperative state. These results were emphasized by the only poor result which (after atelectasis of the anastomosed lung) corresponded functionally to a pneumonectomy. --The two cases of anastomosis of pulmonary artery showed a short survival. Both corresponded to a stage II of tumor classification. Of the other patients (all stage I) three are alive more than five years.