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Related Experiment Videos

Lung function 5 yr after lung volume reduction surgery for emphysema.

A F Gelb1, R J McKenna, M Brenner

  • 1Pulmonary Division, Department of Medicine, Lakewood Regional Medical Center, University of California, Los Angeles, California, USA. afgelb@msn.com

American Journal of Respiratory and Critical Care Medicine
|June 13, 2001
PubMed
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Lung volume reduction surgery (LVRS) offers limited long-term benefits for emphysema patients, with significant mortality and declining improvements in lung function and dyspnea over five years.

Area of Science:

  • Pulmonary Medicine
  • Thoracic Surgery
  • Respiratory Physiology

Background:

  • Limited data exists beyond two years post-lung volume reduction surgery (LVRS) for emphysema.
  • Emphysema significantly impacts patients' quality of life and respiratory function.

Purpose of the Study:

  • To prospectively evaluate the 5-year outcomes of bilateral, targeted upper lobe stapled LVRS in symptomatic emphysema patients.
  • To assess changes in lung function, dyspnea, oxygen dependence, and mortality following LVRS.

Main Methods:

  • Prospective study of 26 symptomatic emphysema patients undergoing video-assisted thoracoscopic surgery (VATS) for bilateral LVRS.
  • Baseline and 5-year follow-up data collected, including forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), dyspnea grade, and oxygen dependence.

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  • Mortality due to respiratory failure was tracked throughout the 5-year period.

    • Main Results:

    • Mortality due to respiratory failure reached 58% by 5 years post-LVRS.
    • Improvements in FEV(1) (>200 ml) and/or FVC (>400 ml) were observed in 8% of patients at 5 years.
    • Dyspnea reduction and elimination of oxygen dependence also showed significant decline over the 5-year period.
    • Some patients experienced a decline in lung function post-LVRS, similar to their pre-operative rate.

    Conclusions:

    • Bilateral LVRS provided palliative clinical and physiological improvement in a decreasing number of patients over 5 years.
    • The long-term benefits of LVRS for emphysema are limited, with substantial mortality and functional decline.
    • Further research is needed to identify optimal candidates and refine surgical techniques for LVRS.