Original ArticlesTwo years’ outcome of lung volume reduction surgery in different morphologic emphysema types☆
Section snippets
Whole cohort
A total of 101 consecutive emphysema patients (38 women) had bilateral LVRS by video-assisted thoracoscopy at our institution between August 1994 and December 1998. Their mean age (± standard error of the mean) at operation was 63 ± 1 years (range, 38 to 78 years). They were severely symptomatic with a mean modified Medical Research Council dyspnea score of 3.6 ± 0.1 and had severe airflow obstruction with a mean forced expiratory volume in one second (FEV1) of 0.78 ± 0.02 L, which was 28% ± 1%
Preoperative findings
The mean age at operation was 66 ± 2 years and did not differ in the three groups. Among 18 patients with markedly heterogeneous emphysema the proportion of men was higher (Table 1)than in the other two groups.
Baseline lung functional variables in percent of their predicted value were not different among the three groups and showed severe airflow obstruction and pulmonary hyperinflation in all patients. Forced expiratory volume in 1 second, forced vital capacity, and vital capacity in absolute
Comment
This prospective follow-up study assessed the duration of benefit of bilateral LVRS in respect to differences in emphysema morphology. We previously showed short-term (ie, at 3 months) improvements of dyspnea, exercise performance, and lung function after bilateral thoracoscopic LVR operation in our study population [5]. We also found the most pronounced amelioration in patients with markedly heterogeneous emphysema, but there was clinically relevant improvement in patients with homogeneous or
Acknowledgements
Supported by grant no. 3200-043358;95.1 from the Swiss National Science Fund and by a grant from the Zürich Lung League.
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