Faculty Collaboration Database

Lung volume reduction surgery. Case selection, operative technique, and clinical results. Ann Surg 1996 May;223(5):526-31; discussion 532-3

Date

05/01/1996

Pubmed ID

8651743

Pubmed Central ID

PMC1235175

DOI

10.1097/00000658-199605000-00008

Scopus ID

2-s2.0-0029944666 (requires institutional sign-in at Scopus site)   94 Citations

Abstract

OBJECTIVE: A clinical study was undertaken to define optimal preoperative strategies and intraoperative techniques that would result in the least morbidity and maximum physiologic improvements in patients with end-stage emphysema selected for lung volume reduction surgery.

BACKGROUND: Lung volume reduction surgery recently has been advocated as an alternative or a bridge to lung transplantation for patients with end-stage chronic obstructive pulmonary disease. The risks, benefits, and long-term results have not been clarified.

METHODS: Twenty-six patients underwent lung volume reduction surgery with a 3-month follow-up on 17 patients. Preoperative and postoperative changes in pulmonary function parameters, quality of life, and oxygen requirement were analyzed. The value of preoperative localization of diseased lung segments and how this affects intraoperative resection is addressed.

RESULTS: Forty-nine percent improvement in FEV1 (forced expiratory volume in 1 second) and 23% improvement in FVC (forced vital capacity) were seen after lung volume reduction surgery. Supplemental oxygen requirement was decreased and 79% of patients reported a much better quality of life. Mortality was 3.8% and air leak morbidity was 18%.

CONCLUSIONS: Lung volume reduction surgery can predictably improve objective and subjective pulmonary function in selected patients with end-stage emphysema with low morbidity and mortality. Careful patient selection, accurate preoperative localization of diseased target areas, skilled anesthetic technique, meticulous operative approach, and intense postoperative support are essential to achieve favorable results.

Author List

Daniel TM, Chan BB, Bhaskar V, Parekh JS, Walters PE, Reeder J, Truwit JD

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient Selection
Pneumonectomy
Postoperative Complications
Pulmonary Emphysema
Respiratory Function Tests
Surgical Stapling
Treatment Outcome
Virginia