[Therapeutic Experience with Three-port Thoracoscopic Lung Volume Reduction Surgery for Emphysema]

Lung volume reduction surgery( LVRS) and lung transplantation have proven to be effective surgical treatments for emphysema. However, since the results of the National Emphysema Treatment Trial (NETT) study, there has been a sharp decline in the number of LVRS cases in Japan, and few patients are eligible for lung transplantation due to donor problems, so bronchoscopic lung volume reduction (BLVR) is expected to be an effective treatment in the future. In our department, LVRS was performed in 22 cases out of approximately 10,000 thoracoscopic procedures from 1999 to 2024. The overall postoperative forced expiratory volume in on second (FEV1.0) improvement rate was 45%, especially 61% for bilateral surgery. If postoperative complications can be safely controlled, LVRS can be expected to have better outcomes than BLVR for bilateral upper lobe dominant forms of emphysema.