Bilateral lung volume reduction surgery outperforms the unilateral approach in functional improvement

Area of Science:

• Pulmonary Medicine
• Thoracic Surgery
• Respiratory Physiology

Background:

• Lung volume reduction surgery (LVRS) is a key intervention for severe pulmonary emphysema.
• Patient selection is crucial for optimizing functional benefits and quality of life.
• The comparative efficacy of unilateral versus bilateral LVRS remains under investigation.

Purpose of the Study:

• To compare the functional outcomes of unilateral versus bilateral LVRS.
• To assess the impact of surgical approach on lung function at 3 and 6 months post-surgery.
• To evaluate changes in forced expiratory volume in 1 second (FEV1) and hyperinflation.

Main Methods:

• Retrospective analysis of 83 patients undergoing LVRS between January 2018 and October 2022.
• Comparison of functional outcomes between unilateral (n=40) and bilateral (n=43) LVRS groups.
• Assessment of FEV1 and residual volume changes at 3 and 6 months post-operation.

Main Results:

• Both unilateral and bilateral LVRS improved FEV1 post-surgery.
• Bilateral LVRS demonstrated significantly greater FEV1 improvement at 3 months (29.2% vs 2.9%) and 6 months (21.5% vs 3%) compared to unilateral LVRS (P<0.05).
• Bilateral LVRS also led to greater reductions in hyperinflation (residual volume) at 3 and 6 months.

Conclusions:

• Bilateral LVRS yields superior functional outcomes compared to unilateral LVRS at 3 and 6 months post-surgery.
• The bilateral approach is associated with enhanced lung function recovery and reduced hyperinflation.
• LVRS, particularly the bilateral approach, offers significant benefits for selected emphysema patients.