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J Thorac Cardiovasc Surg 1996;112:1319-1330
© 1996 Mosby, Inc.
GENERAL THORACIC SURGERY |
Received for publication May 6, 1996; revisions requested June 3, 1996; revisions received July 12, 1996; Accepted for publication July 15, 1996. Address for reprints: Joel D. Cooper, MD, Suite 3108, Queeny Tower, One Barnes Hospital Plaza, St. Louis, MO 63110.
Abstract
Between January 1993 and February 1996, we performed 150 bilateral lung volume reduction procedures for patients with severe emphysema. Patients were selected on the basis of severe dyspnea, increased lung capacity, and a pattern of emphysema that included regions of severe destruction, hyperinflation, and poor perfusion. Twenty percent to 30% of the volume of each lung was excised with the use of a linear stapler and bovine pericardial strips attached to buttress the staple line. Patients were between 36 and 77 years old, with an average 1-second forced expiratory volume of 25% of predicted, total lung capacity of 142% of predicted, and residual volume of 283% of predicted. Ninety-three percent of patients required supplemental oxygen, continuously or with exertion. All patients but one were extubated at the end of the procedure. The 90-day mortality was 4%. Hospital stay progressively decreased with experience, and for the last 50 patients the median hospital stay was 7 days. Prolonged air leakage was the major complication. Results at 6 months show a 51% increase in the 1-second forced expiratory volume and a 28% reduction in the residual volume. The Pao2increased by an average of 8 mm Hg, and 70% of the patients who had previously required continuous supplemental oxygen no longer had this requirement. The improvements in measured pulmonary function were paralleled by a significant reduction in dyspnea and an improvement in the quality of life. Reevaluation at 1 year and 2 years after operation showed the benefit to be well maintained. We conclude that lung volume reduction offers benefits not achievable by any means other than lung transplantation for highly selected patients with severe emphysema. (J THORACCARDIOVASCSURG1996;112:1319-30)
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E. P. INGENITO, J. J. REILLY, S. J. MENTZER, S. J. SWANSON, R. VIN, H. KEUHN, R. L. BERGER, and A. HOFFMAN Bronchoscopic Volume Reduction . A Safe and Effective Alternative to Surgical Therapy for Emphysema Am. J. Respir. Crit. Care Med., July 15, 2001; 164(2): 295 - 301. [Abstract] [Full Text] [PDF]
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B. F. Meyers, R. D. Yusen, T. J. Guthrie, G. Davis, M. S. Pohl, S. S. Lefrak, G. A. Patterson, and J. D. Cooper Outcome of bilateral lung volume reduction in patients with emphysema potentially eligible for lung transplantation J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 10 - 17. [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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A. Pochettino, R. M. Kotloff, B. R. Rosengard, S. M. Arcasoy, N. P. Blumenthal, L. R. Kaiser, and J. E. Bavaria Bilateral versus single lung transplantation for chronic obstructive pulmonary disease: intermediate-term results Ann. Thorac. Surg., December 1, 2000; 70(6): 1813 - 1819. [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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W. CHATILA, S. FURUKAWA, and G. J. CRINER Acute Respiratory Failure after Lung Volume Reduction Surgery Am. J. Respir. Crit. Care Med., October 1, 2000; 162(4): 1292 - 1296. [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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D. Geddes, M. Davies, H. Koyama, D. Hansell, U. Pastorino, J. Pepper, P. Agent, P. Cullinan, S. J. MacNeill, and P. Goldstraw Effect of Lung-Volume-Reduction Surgery in Patients with Severe Emphysema N. Engl. J. Med., July 27, 2000; 343(4): 239 - 245. [Abstract] [Full Text] [PDF]
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P. J. Barnes Chronic Obstructive Pulmonary Disease N. Engl. J. Med., July 27, 2000; 343(4): 269 - 280. [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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E. Pompeo, G. Sergiacomi, I. Nofroni, W. Roscetti, G. Simonetti, and T. C. Mineo Morphologic grading of emphysema is useful in the selection of candidates for unilateral or bilateral reduction pneumoplasty Eur. J. Cardiothorac. Surg., June 1, 2000; 17(6): 680 - 686. [Abstract] [Full Text] [PDF]
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G. A. Lowdermilk, R. J. Keenan, R. J. Landreneau, S. R. Hazelrigg, J. E. Bavaria, L. R. Kaiser, C. A. Keller, and K. S. Naunheim Comparison of clinical results for unilateral and bilateral thoracoscopic lung volume reduction Ann. Thorac. Surg., June 1, 2000; 69(6): 1670 - 1674. [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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A. Brunelli, M. Al Refai, M. Muti, A. Sabbatini, and A. Fianchini Pleural tent after upper lobectomy: a prospective randomized study Ann. Thorac. Surg., June 1, 2000; 69(6): 1722 - 1724. [Abstract] [Full Text] [PDF]
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D. S. Gierada, R. D. Yusen, I. A. Villanueva, T. K. Pilgram, R. M. Slone, S. S. Lefrak, and J. D. Cooper Patient Selection for Lung Volume Reduction Surgery: An Objective Model Based on Prior Clinical Decisions and Quantitative CT Analysis Chest, April 1, 2000; 117(4): 991 - 998. [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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B. R. Celli The Importance of Spirometry in COPD and Asthma : Effect on Approach to Management Chest, February 1, 2000; 117 (2009): 15S - 19S. [Abstract] [Full Text] [PDF]
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 G. I. Bardoczky, L. L. Szegedi, A. A. d’Hollander, J.-M. Moures, P. de Francquen, and J.-C. Yernault Two-Lung and One-Lung Ventilation in Patients with Chronic Obstructive Pulmonary Disease: The Effects of Position and FIO2 Anesth. Analg., January 1, 2000; 90(1): 35 - 35. [Abstract] [Full Text] [PDF]
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K. S. Naunheim, L. R. Kaiser, J. E. Bavaria, S. R. Hazelrigg, M. J. Magee, R. J. Landreneau, R. J. Keenan, J. F. Osterloh, T. M. Boley, and C. A. Keller Long-term survival after thoracoscopic lung volume reduction: a multiinstitutional review Ann. Thorac. Surg., December 1, 1999; 68(6): 2026 - 2031. [Abstract] [Full Text] [PDF]
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