Lung volume reduction surgery: answering the crucial questions

Chest
A M Fein

Abstract

Emphysema and other forms of COPD are not only common, but also have a poor prognosis. Mortality with severe COPD may be as high as 60% at 5 years and is associated with a significant degree of disability and cost to the health-care system. Building on Dr. Otto Brantigan's experience in the 1950s, when multiple-wedge resections of emphysematous lung were performed to decrease lung volume, thereby improving airflow and reducing hyperinflation, recent investigators, utilizing improved surgical and anesthetic technique, have redeveloped a surgical approach to the treatment of emphysema. The operations used to treat emphysema include excision of large bullae (bullectomy) and resection of diffusely emphysematous lung and are variously known as lung volume reduction surgery (LVRS), pneumectomy, and reduction pneumoplasty. These operations aim for a 20 to 30% reduction in lung volume and may be performed by stapler or laser resection, or both. The mechanisms of benefit have been attributed to enhanced elastic recoil, correction of ventilation perfusion mismatch, improved efficiency of respiratory musculature, and improved right ventricular filling. Questions that remain to be answered include duration of benefits, safety, and cost of ...Continue Reading

Citations

Mar 12, 2004·The Journal of Surgical Research·Keith S Naunheim
Jan 8, 2004·Seminars in Thoracic and Cardiovascular Surgery·S A PatelF C Sciurba
May 17, 2000·Current Opinion in Pulmonary Medicine·S A Strassels
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Aug 19, 1999·Thorax·D M Geddes
May 22, 2003·The New England Journal of Medicine·Scott D RamseyUNKNOWN National Emphysema Treatment Trial Research Group
Aug 20, 2005·American Journal of Respiratory and Critical Care Medicine·Robert B GormanSimon C Gandevia
Apr 19, 2016·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Andrea Dell'AmoreRita Melotti
Oct 16, 1999·Anaesthesia and Intensive Care·A U BuettnerA M Weeks
May 26, 2005·American Journal of Respiratory and Critical Care Medicine·Mike Thomas, Chris Griffiths
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Feb 24, 2001·Clinics in Chest Medicine·K R Flaherty, F J Martinez

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