PT  - JOURNAL ARTICLE
AU  - Shahid Sheikh
AU  - Judy Pitts
AU  - Nancy Ryan-Wenger
AU  - Alpa Patel
AU  - Karen Mccoy
TI  - Role of lobectomy in cystic fibrosis
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P1200
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P1200.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P1200.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Patients with cystic fibrosis (CF) have progressive lung disease. A small proportion of CF patients develop localized destruction of the lung and some may develop recurrent hemoptysis or pneumothorax. Objective: To evaluate the usefulness of lung resection in patients with CF and either worsening localized lung disease or recurrent hemoptysis/pneumothorax. Methods: After local IRB approval, we reviewed charts of all patients with CF followed at the CF Center at Nationwide Children’s Hospital, Columbus, OH, who underwent lobectomy over the last 15 years (1995-2010). Patients who were followed for at least one year before surgery were included in this study.Results: Among our cohort of CF patients (n=520), 15 patients were included in this report. Median age 20 years (range 2- 41), 93% Caucasian. Mean %FEV1 was 57%. Four patients died and all had mean %FEV1 <40% before surgery. The median hospital stay was 14 days (range 8-85), median ICU stay was 2 days (range 2-70), and median days with chest tubes were 7 (range 3-25)In the total cohort, there were no significant changes in mean height, weight, BMI, number of hospital and ED visits, or oral and IV antibiotic use over time but within the group with %FEV1>40%, the number of hospital admissions decreased over time (1.5 vs. 0.5, p=.02). Mean % predicted FEV1 decreased over time but the rate of decline in % FEV1 decreased significantly during the second year post-surgery compared to during the first year post-surgery (p=0.007) in patients with less severe disease (%FEV1<40%) (p=0.005). Conclusion: Lobectomy can be useful for some patients with progressive localized lung disease especially if their %FEV1 is >40%. Poor outcomes or lack of clinical improvement are associated with %FEV1 <40%.