Effectiveness of the fold plication method in lung volume reduction surgery

Area of Science:

• Pulmonary Medicine
• Thoracic Surgery
• Surgical Innovation

Background:

• Advanced pulmonary emphysema significantly impairs lung function and quality of life.
• Lung volume reduction surgery (LVRS) aims to alleviate symptoms and improve function in emphysema patients.
• Existing LVRS methods have limitations, necessitating novel approaches.

Purpose of the Study:

• To evaluate the effectiveness of the novel fold plication method for LVRS.
• To assess functional and clinical outcomes in patients with advanced pulmonary emphysema undergoing this new procedure.

Main Methods:

• Twenty consecutive patients with advanced pulmonary emphysema underwent unilateral video-assisted thoracoscopic surgery using the fold plication technique.
• Pulmonary function tests, lung compliance, respiratory pressures, 6-minute walking distance, and Borg scale were assessed pre-operatively and 6 months post-operatively.

Main Results:

• Significant improvements observed in forced expiratory volume in one second (31% increase), forced vital capacity, and maximal voluntary ventilation.
• A notable decrease in functional residual capacity (-16%) and improved exercise tolerance (20% increase in 6-minute walking distance) were recorded.
• Patient-reported dyspnea, measured by the Borg scale, decreased significantly from 5.9 to 3.5.

Conclusions:

• The fold plication method demonstrated favorable outcomes comparable to other LVRS techniques.
• This knifeless stapler-based plication procedure represents a viable alternative for lung volume reduction surgery in selected emphysema patients.