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Surgical approaches for lung volume reduction in emphysema
Samuel J Clark1, Zaid Zoumot, Olivia Bamsey
1NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust and Imperial College London, UK.
Clinical Medicine (London, England)
|April 10, 2014
Summary
Lung volume reduction surgery (LVRS) can improve survival in select chronic obstructive pulmonary disease (COPD) patients. This study found no deaths within 90 days, suggesting LVRS is safe for COPD when performed by a multidisciplinary team.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Medical Guidelines
Background:
- Lung volume reduction surgery (LVRS) is recommended for chronic obstructive pulmonary disease (COPD) based on survival benefits in specific patient groups.
- Despite guidelines, LVRS utilization is low, potentially due to historical concerns regarding surgical risks.
Purpose of the Study:
- To evaluate the safety and outcomes of LVRS and related lung volume reduction procedures.
- To assess if contemporary surgical mortality concerns should deter LVRS in selected COPD patients.
Main Methods:
- Retrospective review of lung volume reduction procedures performed between January 2000 and September 2012.
- Analysis of mortality within 90 days for unilateral LVRS, bullectomy, and intracavity drainage procedures.
Main Results:
- No deaths were recorded within 90 days of unilateral LVRS (n=81), bullectomy (n=20), or intracavity drainage (n=14).
- These findings indicate a low perioperative mortality rate for these procedures.
Conclusions:
- Concerns about surgical mortality should not be a barrier to performing LVRS in carefully selected COPD patients.
- LVRS should be considered in appropriate COPD patients, emphasizing the importance of a multidisciplinary team approach and precise patient selection.
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