Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Thoracoscopic bilateral lung volume reduction for diffuse pulmonary emphysema

Thoracoscopic bilateral lung volume reduction for diffuse pulmonary emphysema Abstract OBJECTIVE: In a prospective study, we investigated the functionalresults, complications and survival of bilateral video-assistedthoracoscopic (VAT) lung volume reduction (LVR) in a selected group ofpatients with severe, nonbullous pulmonary emphysema. From January 1994 toSeptember 1996, 42 of 143 candidates (13 female, 29 male, 42-78 years) wereoperated. They were short of breath on minimal exertion due to severeairflow obstruction and hyperinflation (FEV1 < 30%) pred., TLC > 130%pred., RV > 200% pred.). METHODS: LVR was performed bilaterally by VATusing endoscopic staplers without buttressing the staple lines. Pulmonaryfunction test (PFT), MRC dyspnea score and 12 min walking distance wereassessed preoperatively, at 3, 6 and 12 months. In addition lung functionwas measured at hospital discharge. RESULTS: The patients reported a markedrelief of dyspnea, which persisted at all follow-up visits (P<0.001).FEV1 increased from 0.80 +/- 0.24 (L) to 1.14 +/- 0.41 (L) postoperatively,a 43% gain (P < 0.001). A relevant increase of FEV1 persisted for atleast 1 year. The residual volume to total lung capacity ratio decreasedfrom 0.64 to 0.56 at hospital discharge. The mean 12 min walking distanceincreased from 500 +/- 195 (m) to 770 +/- 222 (m) after 1 year (P <0.001). The mean hospital stay was 13 +/- 5.5 days (median 12.0), drainagetime was 9 +/- 4.3 (median 8.0) days. There was no 30 day mortality. Threepatients died between 2 and 15 months postoperatively by non surgeryrelated reasons. One patient underwent lung transplantation 5 months aftersurgical lung volume reduction. CONCLUSIONS: In a selected group ofpatients with severe, nonbullous pulmonary emphysema, bilateral LVR by VATresults in instantaneous postoperative improvement in pulmonary functionand dyspnea. These favorable effects, including an amelioriation inexercise performance, lasted for at least 1 year. This content is only available as a PDF. © 1997 Elsevier Science B.V. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press

Thoracoscopic bilateral lung volume reduction for diffuse pulmonary emphysema

European Journal of Cardio-Thoracic Surgery , Volume 11 (6) – Jun 1, 1997

Loading next page...
 
/lp/oxford-university-press/thoracoscopic-bilateral-lung-volume-reduction-for-diffuse-pulmonary-IOvHH50fo0

References (25)

Publisher
Oxford University Press
Copyright
© 1997 Elsevier Science B.V.
Subject
Articles
ISSN
1010-7940
eISSN
1873-734X
DOI
10.1016/S1010-7940(97)00088-2
Publisher site
See Article on Publisher Site

Abstract

Abstract OBJECTIVE: In a prospective study, we investigated the functionalresults, complications and survival of bilateral video-assistedthoracoscopic (VAT) lung volume reduction (LVR) in a selected group ofpatients with severe, nonbullous pulmonary emphysema. From January 1994 toSeptember 1996, 42 of 143 candidates (13 female, 29 male, 42-78 years) wereoperated. They were short of breath on minimal exertion due to severeairflow obstruction and hyperinflation (FEV1 < 30%) pred., TLC > 130%pred., RV > 200% pred.). METHODS: LVR was performed bilaterally by VATusing endoscopic staplers without buttressing the staple lines. Pulmonaryfunction test (PFT), MRC dyspnea score and 12 min walking distance wereassessed preoperatively, at 3, 6 and 12 months. In addition lung functionwas measured at hospital discharge. RESULTS: The patients reported a markedrelief of dyspnea, which persisted at all follow-up visits (P<0.001).FEV1 increased from 0.80 +/- 0.24 (L) to 1.14 +/- 0.41 (L) postoperatively,a 43% gain (P < 0.001). A relevant increase of FEV1 persisted for atleast 1 year. The residual volume to total lung capacity ratio decreasedfrom 0.64 to 0.56 at hospital discharge. The mean 12 min walking distanceincreased from 500 +/- 195 (m) to 770 +/- 222 (m) after 1 year (P <0.001). The mean hospital stay was 13 +/- 5.5 days (median 12.0), drainagetime was 9 +/- 4.3 (median 8.0) days. There was no 30 day mortality. Threepatients died between 2 and 15 months postoperatively by non surgeryrelated reasons. One patient underwent lung transplantation 5 months aftersurgical lung volume reduction. CONCLUSIONS: In a selected group ofpatients with severe, nonbullous pulmonary emphysema, bilateral LVR by VATresults in instantaneous postoperative improvement in pulmonary functionand dyspnea. These favorable effects, including an amelioriation inexercise performance, lasted for at least 1 year. This content is only available as a PDF. © 1997 Elsevier Science B.V.

Journal

European Journal of Cardio-Thoracic SurgeryOxford University Press

Published: Jun 1, 1997

There are no references for this article.