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Robotic-assisted Left Pneumonectomy For Vanishing Lung Syndrome

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Volume reduction surgery impairs immediate postoperative pulmonary function in canine emphysema.

Gordon Buduhan¹, Lawrence Tan, Krika Kasian

¹Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.

American Journal of Respiratory and Critical Care Medicine

|October 7, 2006

Summary

Lung volume reduction surgery (LVRS) acutely impairs lung mechanics in emphysema models. This immediate post-operative effect may explain complications and mortality associated with LVRS.

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Published on: December 17, 2014

Area of Science:

Pulmonary Medicine
Surgical Research
Respiratory Physiology

Background:

Lung volume reduction surgery (LVRS) benefits selected emphysema patients long-term.
Immediate post-operative changes in lung function and maximal flow (Vmax) after LVRS are unclear.
These acute changes may contribute to high morbidity and mortality rates.

Purpose of the Study:

To investigate the immediate effects of LVRS on lung function and Vmax.
To utilize a chronic canine model of upper lobe emphysema for this investigation.

Main Methods:

Bilateral upper lobe emphysema was induced using papain.
LVRS was performed using a vacuum-assisted surgical system.
Lung mechanics, Vmax, and intrabronchial pressures were measured pre- and post-surgery.

Main Results:

Emphysema increased total lung capacity and reduced Vmax.
Post-LVRS, tidal respiratory compliance and Vmax decreased.
Lung elastic recoil and frictional resistance increased post-LVRS in both emphysema and control groups.

Conclusions:

Acute LVRS impairs lung mechanical properties.
These impairments may lead to ventilatory complications.
Difficulty in weaning from mechanical ventilation and mortality may be linked to these acute changes.