Lung volume reduction surgery: technique, operative mortality, and morbidity

Area of Science:

• Pulmonary Medicine
• Thoracic Surgery
• Cardiothoracic Surgery

Background:

• Emphysema significantly impacts quality of life, causing severe dyspnea.
• Lung volume reduction surgery (LVRS) offers a palliative option for select patients.
• Multidisciplinary expertise is crucial for successful LVRS programs.

Purpose of the Study:

• To review the evolution of LVRS practices.
• To emphasize technical aspects and complications of LVRS.
• To highlight the impact of the National Emphysema Treatment Trial (NETT).

Main Methods:

• Analysis of perioperative outcomes.
• Establishment of a bilateral, stapled approach as standard care.
• Utilizing data from the National Emphysema Treatment Trial (NETT), the largest multi-center randomized trial.

Main Results:

• NETT enrolled diverse emphysema patterns, providing robust evidence.
• Data guides refinement of patient selection criteria for LVRS.
• Benchmarks for survival, complications, and durability of response have been established.

Conclusions:

• Appropriate patient selection and preparation are key to successful LVRS.
• NETT data is instrumental in optimizing LVRS patient care and outcomes.
• Understanding surgical techniques and complications is vital for effective LVRS.