Outcome after unilateral lung volume reduction surgery in patients with severe emphysema

Geiser, Thomas; Schwizer, Bernhard; Krueger, Thorsten; Gugger, Matthias; Im Hof, Vinzenz; Dusmet, Michael; Fitting, Jean-William; Ris, Hans-Beat (2001). Outcome after unilateral lung volume reduction surgery in patients with severe emphysema. European journal of cardio-thoracic surgery, 20(4), pp. 674-678. Elsevier Science B.V. 10.1016/S1010-7940(01)00845-4

[img]
Preview
Text
20-4-674.pdf - Published Version
Available under License Publisher holds Copyright.

Download (143kB) | Preview

Objective: Bilateral lung volume reduction surgery (LVRS) has emerged as a palliative treatment option in patients with severe pulmonary emphysema. However, it is not known if a sustained functional improvement can be obtained using an unilateral approach. Methods: We hypothesized that a palliative effect can also be obtained by unilateral LVRS and prospectively assessed lung function, walking distance, and dyspnea before and 3, 6, 12, 18, 24 and 36 months after unilateral LVRS. Results: Twenty-eight patients were operated by the use of video-assisted thoracoscopic surgery (VATS) with a mean follow-up of 16.5 months (range 3–36 months). Forced expiratory volume in 1 s (FEV1) was significantly improved up to 3 months (1007±432 compared to 1184±499 ml, P≪0.001), residual volume up to 24 months (4154±1126 compared to 3390±914 ml, P≪0.01), dyspnea up to 12 months (modified Borg dyspnea scale 6.6±1.8 compared to 3.9±1.8, P=0.01) and walking distance up to 24 months (343±107 compared to 467±77 m, P≪0.05) after unilateral LVRS compared to preoperative values. Overall, 25 of 28 patients reported a subjective benefit after unilateral LVRS. There was no 30-day mortality. Only two patients required surgery on the contralateral side after 4.5 and 6 months, respectively, both suffering from α-1-antitrypsin deficiency. Conclusions: Unilateral LVRS by the use of VATS results in a sustained beneficial effect, improving walking distance and dyspnea for up to 24 months in patients with severe emphysema. The preservation of the contralateral side for future intervention if required renders unilateral LVRS an attractive concept in this difficult palliative situation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Geiser, Thomas and Gugger, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1010-7940

Publisher:

Elsevier Science B.V.

Language:

English

Submitter:

Marceline Brodmann

Date Deposited:

07 Oct 2020 09:23

Last Modified:

07 Oct 2020 09:23

Publisher DOI:

10.1016/S1010-7940(01)00845-4

BORIS DOI:

10.7892/boris.114999

URI:

https://boris.unibe.ch/id/eprint/114999

Actions (login required)

Edit item Edit item
Provide Feedback