[Lung Volume Reduction Surgery for Severe Emphysema].

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Devices

Background:

• Severe emphysema often necessitates advanced surgical interventions when medical therapy fails.
• Lung volume reduction surgery (LVRS) is a recognized treatment option for eligible patients.
• Challenges in preoperative assessment can impact surgical planning for emphysema patients.

Purpose of the Study:

• To report favorable outcomes of two cases undergoing Lung Volume Reduction Surgery (LVRS).
• To describe a specific surgical technique involving cyst wall resection with fibrin glue and polyglycolic acid (PGA) sheets.
• To highlight the utility of minimally invasive thoracoscopic LVRS in complex emphysema cases.

Main Methods:

• Minimally invasive LVRS performed via a thoracoscopic approach.
• Surgical technique involved cyst wall incision, fibrin glue and PGA sheet application to the cyst base, and resection with an automatic suturing device.
• Case 1: Patient with preoperative respiratory failure and home oxygen therapy. Case 2: Patient with a giant cyst and coexisting pneumothorax.

Main Results:

• Both reported cases of LVRS resulted in favorable patient outcomes.
• The described technique facilitated successful lung volume reduction.
• Minimally invasive LVRS proved effective in a patient with severe preoperative respiratory compromise.
• The second case illustrated challenges in differentiating conditions preoperatively, despite successful surgical management.

Conclusions:

• Minimally invasive LVRS, utilizing fibrin glue and PGA sheets, is a viable and effective treatment for severe emphysema.
• This surgical approach can yield positive results even in patients with significant preoperative respiratory failure.
• Careful preoperative evaluation is crucial, though challenging, in cases involving complex cyst formations and pneumothorax.