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Lung volume reduction surgery: an overview.

Rodrigo Afonso da Silva Sardenberg1, Riad Naim Younes, Daniel Deheizelin

  • 1Hospital AC Camargo, São Paulo, SP.

Revista Da Associacao Medica Brasileira (1992)
|January 29, 2011
PubMed
Summary

This review examines lung volume reduction surgery (LVRS) for advanced emphysema, analyzing its efficacy and safety. Further randomized trials are needed for definitive conclusions on LVRS versus medical management.

Area of Science:

  • Pulmonary Medicine
  • Thoracic Surgery

Background:

  • Advanced emphysema significantly impacts patient quality of life and lung function.
  • Lung volume reduction surgery (LVRS) is a therapeutic option for select patients with severe COPD.
  • The efficacy, safety, and feasibility of LVRS require ongoing evaluation.

Purpose of the Study:

  • To review the existing literature on the efficacy, safety, and feasibility of LVRS in advanced emphysema patients.
  • To compare medical therapy with surgical interventions for emphysema.
  • To identify key factors influencing LVRS outcomes, including perioperative morbidity and mortality.

Main Methods:

  • Systematic literature review of studies published between January 1995 and December 2009.
  • Searched PubMed (MEDLINE) and Cochrane Library using keywords related to LVRS and COPD.

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  • Included randomized controlled trials, controlled clinical trials, reviews, and case series; excluded bullous emphysema.

    • Main Results:

    • Interpretation of early clinical data on LVRS is complicated by issues of validity, follow-up bias, and selection criteria.
    • Analysis included perioperative outcomes and lung function measurements (e.g., FEV1) for various emphysema distributions.
    • Surgical approaches varied, including sternotomy, thoracotomy, and videothoracoscopy.

    Conclusions:

    • The review highlights challenges in definitively assessing LVRS due to data limitations.
    • Prospective randomized trials comparing medical management and LVRS are crucial for establishing its role in advanced emphysema treatment.
    • Further research is essential to provide a final assessment of LVRS efficacy and safety.