Effect and duration of lung volume reduction surgery: mid-term results of the Brompton trial.

The Thoracic and Cardiovascular Surgeon
E LimP Goldstraw

Abstract

Although many studies have reported improvement in lung function following LVRS, the magnitude of improvement and subsequent decline has not been evaluated against medical therapy after the second year. Existing pulmonary function records were collapsed for ech participant since randomisation from Brompton LVRS trial cohort. Longitudinal data analysis was used to profile th history of medically treated patients and the effect of LVRS. Pulmonary function results were collated from survivors over a median of 25 (17 to 39) months. The estimated immediate increase in mean FEV1, following surgery was +0.2591 (0.179, 0.339), with a rate of change of -0.0051 (-0.009, -0.001) per month compared to medical therapy (p < 0.001). The changes in the secondary outcome measures (LVRS compared to medical therapy) were an increase in FVC (p = 0.004), decrease in RV (p < 0.001) and TLC (p < 0.001), with differences that were maintained over time. The initial reduction in RV/TLC ration was sustained (p < 0.001), but the estimated initial increase in peak flow was accompanied by a gradual decline that was not statistically significant (p = 0.062). KCOc showed no immediate change, but there was a gradual sustained increase with time (p = 0.009). Me...Continue Reading

Citations

Jan 15, 2011·Journal of Applied Physiology·George CremonaPeter D Wagner
Jun 7, 2008·American Journal of Respiratory and Critical Care Medicine·Margaret L SnyderUNKNOWN National Emphysema Treatment Trial Research Group
Feb 11, 2014·Clinics in Chest Medicine·Patrick Brian MurphyMichael Iain Polkey

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