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Lung volume reduction surgery results in pulmonary emphysema. Changes in pulmonary function
Y Yoshinaga1, A Iwasaki, K Kawahara
1Second Department of Surgery, School of Medicine, Fukuoka University, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|October 8, 1999
Summary
Lung volume reduction surgery significantly improved symptoms and lung function in patients with severe pulmonary emphysema. Improvements were maintained for up to two years post-surgery.
Area of Science:
- Pulmonary Medicine
- Thoracic Surgery
Background:
- Severe pulmonary emphysema significantly impairs lung function and quality of life.
- Lung volume reduction surgery (LVRS) is a therapeutic option for select patients.
Purpose of the Study:
- To evaluate the efficacy and safety of LVRS in patients with severe pulmonary emphysema without giant bullae.
- To compare outcomes between unilateral and bilateral LVRS, and between thoracoscopic and median sternotomy approaches.
Main Methods:
- A retrospective analysis of 57 patients undergoing LVRS between December 1993 and August 1998.
- Procedures included unilateral (26) and bilateral (31) LVRS, utilizing thoracoscopy or median sternotomy.
- Symptom scores and pulmonary function tests, including forced expiratory volume in 1 second (FEV1), were analyzed.
Main Results:
- Bilateral LVRS, via both thoracoscopy and median sternotomy, demonstrated significant improvements in symptoms and pulmonary function.
- Mean FEV1 improvement was 42.4% for bilateral thoracoscopic LVRS and 60.0% for bilateral median sternotomy.
- Unilateral LVRS resulted in a mean FEV1 improvement of 28.9% with no significant complications.
- Improvements were sustained at 1 and 2-year follow-ups.
Conclusions:
- LVRS is an effective treatment for severe pulmonary emphysema without giant bullae.
- Bilateral LVRS, particularly via median sternotomy, offers substantial functional gains.
- The positive effects of LVRS are durable, with sustained improvements observed up to two years post-procedure.