Treating heterogeneous emphysema by lung volume reduction surgery using one-way valve stent implantation

To retrospectively analyze the efficacy and complications of lung volume reduction surgery (LVRS) using one-way valve stent implantation in three heterogeneous emphysema cases.

We performed bronchoscopic, lung CT, pulmonary function (PF) and 6-minute walk distance (6MWD) tests respectively before operation and 1 month, and 3 and 6 months after operation to estimate the surgical effects in the 3 cases by comparing the test results.

After operation, all the three cases had worsened symptoms of cough and expectoration; two of them had hemoptysis, EVB-related infections and acute exacerbation of chronic obstructive pulmonary disease (AECOPD), one of them had airway distortion and respiratory failure and still one of them had granulation hyperplasia. Postoperative reexamination results revealed that one patient had obviously increased forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and 6-minute walk distance (6MWD) and right upper pulmonary atelectasis, but no apparent improvements in FEV1, FVC, and 6MWD were found in the other two patients.

The patient with postoperative pulmonary atelectasis was found with significantly improved PF at the first month after surgery, but the PFs thereof had a drop at the sixth month after surgery due to EVB-related infections. No obvious improvements in the PFs of all the three patients were observed in the reexamination performed six months after surgery. The long-term effects of LVRS with one-way valve stent implantation are uncertain, and further studies should be carried out in the future.