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Successful Lung Volume Reduction Surgery after Endobronchial Coils Treatment in a Severe Emphysematous Patient
Hervé Dutau1, Gaëtan Deslée2, Fabienne Bregeon3,4
1Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, North University Hospital, Marseille, France, hdutau@ap-hm.fr.
Abstract:
Lung volume reduction surgery (LVRS) in emphysema has demonstrated improvement in both overall survival and clinical/functional outcomes. Endobronchial coil treatment (ECT) has also demonstrated improvement in pulmonary function, exercise performance, and quality of life, although predictive factors of responders remain to be determined. We describe the first successful LVRS in an emphysematous patient who displayed no benefit, either clinically or functionally, from a previous ECT. LVRS was performed in the right lower lobe 4 years after ECT in the same lobe. An air leak persisted for 18 days after LVRS, with no requirement for surgery or endobronchial treatment. Six months after LVRS, the patient dramatically improved with a decrease in hyperinflation and dyspnea.
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Consider a gas confined to a cylinder fitted with a movable piston at one end. If the gas expands from volume V1 to volume V2, it exerts a force on the piston, such that the piston moves by a distance dr.
The work done by the gas on the piston can be expressed as

