Abstract
Introduction: Lung surgery reduction is a known method which can improve the quality of life for certain COPD. Parts of the lung that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work better.
Clinical features: The work presents a patient with stage IV COPD admitted in our service after a severe decompensation. Comorbidities: severe obesity, chronic coronary ischemic disease and diabetes, left pneumotorax (secondary a giant bulla of emphysema) and infectious pneumonia. We maintained the antibiotherapy and we aplied an anterior pleurotomy on the left medioclavicular line. The evolution was initially good with suppression of the tracheotomy's canule and of the pleurotomy's tube in five days.
Surgery: 48 hours after removing the chest tube, the pneumotorax recedived and we decided the surgery treatment. We performed the resection of the giant bulla and mechanical pleurodesis.
After opening of the bulla we used a fold of visceral pleura to covering the cavity in separated points.
The outcomes: The postoperator evolution was very good with spontan closure of the traheostomy and with ablation of the tube in a week.The respiratory test indicated a improved with 15%.
Discussion Lung volume reduction surgery is indicated in selected cases, after surgery both lung functional tests and clinical performance of the patient beeing improved.
- © 2011 ERS
