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J Thorac Cardiovasc Surg 1995;109:106-119
© 1995 Mosby, Inc.
GENERAL THORACIC SURGERY |
St. Louis, Mo.
From the Division of Cardiothoracic Surgery, Department of Surgery, Department of Anesthesiology, Division of Pulmonary and Critical Care Medicine, and the Department of Medicine, Washington University School of Medicine, St. Louis, Mo.
Address for reprints: Joel D. Cooper, MD, Suite 3108, Queeny Tower, One Barnes Hospital Plaza,St. Louis, MO 63110.
Abstract
We undertook surgical bilateral lung volume reduction in 20 patients with severe chronic obstructive pulmonary disease to relieve thoracic distention and improve respiratory mechanics. The operation, done through median sternotomy, involves excision of 20% to 30% of the volume of each lung. The most affected portions are excised with the use of a linear stapling device fitted with strips of bovine pericardium attached to both the anvil and the cartridge to buttress the staple lines and eliminate air leakage through the staple holes. Preoperative and postoperative assessment of results has included grading of dyspnea and quality of life, exercise performance, and objective measurements of lung function by spirometry and plethysmography. There has been no early or late mortality and no requirement for immediate postoperative ventilatory assistance. Follow-up ranges from 1 to 15 months (mean 6.4 months). The mean forced expiratory volume in 1 second has improved by 82% and the reduction in total lung capacity, residual volume, and trapped gas has been highly significant. These changes have been associated with marked relief of dyspnea and improvement in exercise tolerance and quality of life. Although the follow-up period is short, these preliminary results suggest that bilateral surgical volume reduction may be of significant value for selected patients with severe chronic obstructive pulmonary disease. (J THORAC CARDIOVASC SURG 1995;109:106-9)
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E. P. INGENITO, S. H. LORING, M. L. MOY, S. J. MENTZER, S. J. SWANSON, A. HUNSAKER, C. C. MCKEE, and J. J. REILLY Comparison of Physiological and Radiological Screening for Lung Volume Reduction Surgery Am. J. Respir. Crit. Care Med., April 1, 2001; 163(5): 1068 - 1073. [Abstract] [Full Text]
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M. CASSART, J. HAMACHER, Y. VERBANDT, S. WILDERMUTH, D. RITSCHER, E. W. RUSSI, P. de FRANCQUEN, M. CAPPELLO, W. WEDER, and M. ESTENNE Effects of Lung Volume Reduction Surgery for Emphysema on Diaphragm Dimensions and Configuration Am. J. Respir. Crit. Care Med., April 1, 2001; 163(5): 1171 - 1175. [Abstract] [Full Text]
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B. Murtuza, B. F. Keogh, A. K. Simonds, and J. R. Pepper Lung volume reduction surgery in a ventilated patient with severe pulmonary emphysema Ann. Thorac. Surg., March 1, 2001; 71(3): 1037 - 1038. [Abstract] [Full Text] [PDF]
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J. B. Shrager, D.-K. Kim, Y. J. Hashmi, E. B. Lankford, P. Wahl, H. H. Stedman, S. Levine, and L. R. Kaiser Lung volume reduction surgery restores the normal diaphragmatic length-tension relationship in emphysematous rats J. Thorac. Cardiovasc. Surg., February 1, 2001; 121(2): 0217 - 224. [Abstract] [Full Text] [PDF]
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 Y. Lacasse, I. Ferreira, D. Brooks, T. Newman, and R. S. Goldstein Critical Appraisal of Clinical Practice Guidelines Targeting Chronic Obstructive Pulmonary Disease Arch Intern Med, January 8, 2001; 161(1): 69 - 74. [Abstract] [Full Text] [PDF]
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S. Ahmed, K. A. Marzouk, T. A. Bhuiya, M. Iqbal, and L. J. Rossoff Asymptomatic Expectoration of Surgical Staples Complicating Lung Volume Reduction Surgery Chest, January 1, 2001; 119(1): 307 - 308. [Abstract] [Full Text] [PDF]
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U. Stammberger, W. Klepetko, G. Stamatis, J. Hamacher, R. A. Schmid, W. Wisser, L. Hillerjan, and W. Weder Buttressing the staple line in lung volume reduction surgery: a randomized three-center study Ann. Thorac. Surg., December 1, 2000; 70(6): 1820 - 1825. [Abstract] [Full Text] [PDF]
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R. M. Rogers, H. O. Coxson, F. C. Sciurba, R. J. Keenan, K. P. Whittall, and J. C. Hogg Preoperative Severity of Emphysema Predictive of Improvement After Lung Volume Reduction Surgery : Use of CT Morphometry Chest, November 1, 2000; 118(5): 1240 - 1247. [Abstract] [Full Text] [PDF]
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J. C. Baldwin, C. C. Miller III, R. A. Prince, and R. Espada Chest radiograph heterogeneity predicts functional improvement with volume reduction surgery Ann. Thorac. Surg., October 1, 2000; 70(4): 1208 - 1211. [Abstract] [Full Text] [PDF]
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E. Pompeo, M. Marino, I. Nofroni, G. Matteucci, and T. C. Mineo Reduction pneumoplasty versus respiratory rehabilitation in severe emphysema: a randomized study Ann. Thorac. Surg., September 1, 2000; 70(3): 948 - 953. [Abstract] [Full Text] [PDF]
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W. Wisser, O. Senbaklavaci, C. Ozpeker, M. Ploner, T. Wanke, E. Tschernko, E. Wolner, and W. Klepetko Is long-term functional outcome after lung volume reduction surgery predictable? Eur. J. Cardiothorac. Surg., June 1, 2000; 17(6): 666 - 672. [Abstract] [Full Text] [PDF]
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K. S. Naunheim, S. R. Hazelrigg, L. R. Kaiser, R. J. Keenan, J. E. Bavaria, R. J. Landreneau, J. Osterloh, and C. A. Keller Risk analysis for thoracoscopic lung volume reduction: a multi-institutional experience Eur. J. Cardiothorac. Surg., June 1, 2000; 17(6): 673 - 679. [Abstract] [Full Text] [PDF]
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I. N. Glaspole, E. Gabbay, J. A. Smith, M. Rabinov, and G. I. Snell Predictors of perioperative morbidity and mortality in lung volume reduction surgery Ann. Thorac. Surg., June 1, 2000; 69(6): 1711 - 1716. [Abstract] [Full Text] [PDF]
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J. Hamacher, E. W. Russi, and W. Weder Lung Volume Reduction Surgery : A Survey on the European Experience Chest, June 1, 2000; 117(6): 1560 - 1567. [Abstract] [Full Text] [PDF]
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K. Suga, T. Tsukuda, H. Awaya, N. Matsunaga, K. Sugi, and K. Esato Interactions of Regional Respiratory Mechanics and Pulmonary Ventilatory Impairment in Pulmonary Emphysema : Assessment With Dynamic MRI and Xenon-133 Single-Photon Emission CT Chest, June 1, 2000; 117(6): 1646 - 1655. [Abstract] [Full Text] [PDF]
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 M. A. de Castro Current Controversies in Surgical Therapy for Emphysema Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2000; 4(1): 26 - 30. [Abstract] [PDF]
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M. Brenner, R. J. McKenna Jr, J. C. Chen, D. L. Serna, L. L. Powell, A. F. Gelb, R. J. Fischel, and A. F. Wilson Relationship between amount of lung resected and outcome after lung volume reduction surgery Ann. Thorac. Surg., February 1, 2000; 69(2): 388 - 393. [Abstract] [Full Text] [PDF]
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U. Stammberger, R. Thurnheer, R. A. Schmid, E. W. Russi, and W. Weder Redo lung volume reduction surgery in a patient with {alpha}1-antitrypsin deficiency Ann. Thorac. Surg., February 1, 2000; 69(2): 632 - 633. [Abstract] [Full Text] [PDF]
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D. L. Serna, M. Brenner, K. E. Osann, R. J. McKenna Jr, J. C. Chen, R. J. Fischel, B. U. Jones, A. F. Gelb, and A. F. Wilson SURVIVAL AFTER UNILATERAL VERSUS BILATERAL LUNG VOLUME REDUCTION SURGERY FOR EMPHYSEMA J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1101 - 1109. [Abstract] [Full Text] [PDF]
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