PT - JOURNAL ARTICLE AU - Katrin Hornemann AU - Daniela Gompelmann AU - Felix J.F. Herth AU - Claus P. Heussel AU - Hans Hoffmann AU - Ralf Eberhardt TI - Lung volume reduction surgery (LVRS) after endoscopic lung volume reduction (ELVR) in severe emphysema - A case series DP - 2012 Sep 01 TA - European Respiratory Journal PG - P2945 VI - 40 IP - Suppl 56 4099 - http://erj.ersjournals.com/content/40/Suppl_56/P2945.short 4100 - http://erj.ersjournals.com/content/40/Suppl_56/P2945.full SO - Eur Respir J2012 Sep 01; 40 AB - BackgroundLVRS as well as ELVR can improve patients symptoms, wellbeing and pulmonary function testing. ELVR can be performed in upper and lower lobe emphysema. LVRS is currently not recommended for patients with very low FEV1 or lower lobe emphysema.ObjectivesCase series to establish if surgical lobectomy after initially successful ELVR is effective and safe.Methods6 patients (4 female, mean age 60.3 y, mean FEV1 640 ± 214 ml) with severe lower lobe emphysema received ELVR and showed an initial but not persistent improvement. Hence a lobectomy was performed for surgical lung volume reduction. Pulmonary function tests (PFT), 6-minute-walk-test (6MWT) and dyspnea score (mMRC) were performed 90 days after surgery and safety issues were assessed.ResultsIn all cases lobectomy of one lower lobe (5 left, 1 right side) was performed without any problems. No prolonged air leack and no 30-days mortality were observed. 1 patient was lost for follow up. He died 86 days after the procedure due to an acute tension pneumothorax, but showed a primary clinical benefit. In the remaining 5 cases an improvement of +42.4 ± 16.3 % in FEV1 and reduction of - 35.1 ± 17.4 % in residual volume (RV) was seen. Both 6MWT (+72 ± 43 m) and mMRC (+2.6 ± 1.1 points) were also improved.ConclusionA lobectomy in patients with severe lower lobe emphysema for definitive LVRS seems to be effective and safe in selected cases. A previous successful ELVR can be used as a pretest for adequate patient selection.