[Lung volume reduction surgery for pulmonary emphysema--report of two cases]

Lung volume reduction surgery (LVR) was practiced in 2 male patients with pulmonary emphysema to improve pulmonary function. On admission, they complained of exertional dyspnea (Grade III of the Hugh-Jones dyspnea scale). Computed tomographic scan (band display) revealed emphysematous changes throughout both lung fields, especially in bilateral upper lobes. Nuclear lung perfusion scintigraphy showed markedly diminished blood flow in both upper lobes. The bilateral upper lobes of each patient were excised through median sternotomy using the linear stapling device. The staple lines were buttressed with bioabsorbable polyglycolic acid fabric. At 1 month after LVR, the forced expiratory volume in 1 second improved, respectively, from 0.51 L to 1.27 L (Case 1) and from 0.68 L to 0.85 L (case 2). In conclusion, LVR was useful to improve pulmonary function of the patients with pulmonary emphysema.