[Lung volume reduction surgery for emphysema. Long term results].

Area of Science:

• Pulmonary Medicine
• Thoracic Surgery
• Respiratory Physiology

Background:

• Emphysema significantly impairs lung function and quality of life.
• Lung Volume Reduction Surgery (LVRS) is a therapeutic option for severe emphysema.
• Patient selection is crucial for successful LVRS outcomes.

Purpose of the Study:

• To evaluate the long-term efficacy of LVRS in improving lung function and physical performance.
• To assess changes in dyspnea and exercise capacity following LVRS.
• To determine the safety and outcomes of LVRS in a cohort of emphysema patients.

Main Methods:

• Prospective analysis of 19 emphysema patients undergoing LVRS.
• Surgical resection of 20-30% of lung volume using stapling and bovine pericardium.
• Evaluation of pulmonary function (FEV1, FVC, RV) and physical performance (6-minute walk test, MRC dyspnea index) at multiple time points (3-48 months).

Main Results:

• Significant improvements in FEV1, FVC, and 6-minute walk test observed at 3, 12, 24, and 36 months post-surgery.
• Marked reduction in residual volume (RV) and dyspnea index.
• Average FEV1 increase reached up to 72% at 12 months, with sustained benefits up to 48 months.
• Acceptable morbidity and mortality rates reported.

Conclusions:

• LVRS offers significant and sustained improvements in lung function, exercise capacity, and dyspnea in selected emphysema patients.
• The optimal benefits are typically observed between 3 and 12 months post-surgery.
• LVRS is a viable treatment option with acceptable safety profile for carefully selected patients with severe emphysema.