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Clinical Investigations: Lung Volume Reduction SurgeryRate of FEV1 Change Following Lung Volume Reduction Surgery
Section snippets
Materials and Methods
All patients who underwent LVRS at Chapman Medical Center from May 1994 to July 1996 were included in this evaluation. Patients underwent baseline complete pulmonary function testing, including the following: spirometry, gas exchange measures (room air arterial blood gas measurement, diffusion of carbon monoxide), plethysmography, and gas dilution lung volumes (Table 1). Maximum inspiratory and expiratory flow volume curves and thoracic gas volume were measured in a plethysmograph
Composite Results in All Patients
A total of 376 patients underwent LVRS in this program during the analysis interval: 46 patients underwent unilateral laser LVRS; 111 had unilateral thoracoscopic staple LVRS; 184 had bilateral thoracoscopic staple LVRS; 21 had mixed thoracoscopic laser and staple procedures; and 14 had bilateral staple LVRS via median sternotomy. There were 15 perioperative deaths (mortality rate, 3.98%). In the overall group; follow-up pulmonary function results are available on 331 of the 361 surviving
Discussion
LVRS has been shown to be acutely effective in providing palliative improvement in pulmonary function in patients with heterogeneous emphysema in a number of studies.1, 2, 3, 4, 5, 6,9,12, 13, 14, 15, 16, 17 Postoperative pulmonary function appears to maximize at approximately 3 to 6 months following surgery. Limited available data suggest that benefit may be sustained for at least 1 to 2 years following surgery in most patients.4, 17 However, there is widely variable response to surgery as
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Patient-directed Volume Reduction for Emphysema: Sequential Surgical and Endobronchial Techniques
2021, Annals of Thoracic SurgeryLung volume reduction for severe emphysema: good things come in small packages
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2012, Trends in Anaesthesia and Critical CareCitation Excerpt :There is no evidence of better mortality figures or pulmonary function with any particular appraach9 but VATS may result in fewer cases of post-operative respiratory failure and provides earlier recovery with lower costs when compared to sternotomy.14 A greater improvement in lung function is seen after bilateral surgery, but the rate of decline in pulmonary function is also greater.15 Serious morbidity is not an infrequent complication of LVRS, whichever surgical technique is used.
Randomized comparison of awake nonresectional versus nonawake resectional lung volume reduction surgery
2012, Journal of Thoracic and Cardiovascular SurgeryStaged Lung Volume Reduction Surgery-Rationale and Experience
2009, Thoracic Surgery Clinics
Supported in part by DOE grant DE-F603-91ER61227, ALA grant CI-030-N, CTRDRP No. 6RT-0158, and a Chapman Medical Center Research Grant.