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Published on: March 8, 2019
Surgical treatment for pulmonary emphysema
Summary
Surgical treatment for emphysema can improve disabling dyspnea in select patients. Removing destroyed lung areas and preserving vascularized tissue offers functional benefits, but requires careful postoperative care.
Area of Science:
- Pulmonary Medicine
- Thoracic Surgery
- Emphysema Research
Background:
- Surgical intervention for emphysema is considered based on specific in-vivo observations of disease distribution.
- Emphysema is characterized by destructive changes, often not generalized, with central areas less affected.
Observation:
- Destructive changes in emphysema are rarely uniform.
- Central lung regions are often less impacted by emphysematous destruction.
- Marginal folding can cause obstruction in otherwise normal lung tissue.
Findings:
- Surgical removal of avascular, space-occupying emphysematous areas can allow compressed lung to expand.
- Pulmonary angiography accurately defines destructive emphysema extent and identifies viable capillary circulation.
- In 47 patients, surgery yielded a 21% mortality rate but a 45% long-term improvement in disabling dyspnea.
Implications:
- Surgical treatment is a viable option for emphysema with significant space occupation and demonstrable alveolar vascularization in adjacent lung.
- Limited resections preserving vascularized lung tissue are preferred.
- Prompt hemithorax obliteration and respiratory intensive care are crucial for managing postoperative complications.
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