@article {Gelb928, author = {AF Gelb and RJ McKenna and M Brenner and R Fischel and N Zamel}, title = {Lung function after bilateral lower lobe lung volume reduction surgery for alpha1-antitrypsin emphysema}, volume = {14}, number = {4}, pages = {928--933}, year = {1999}, doi = {10.1034/j.1399-3003.1999.14d33.x}, publisher = {European Respiratory Society}, abstract = {This study explores the mechanism(s) of airflow limitation following lung volume reduction surgery (LVRS) in patients with emphysema due to homozygous alpha1-antitrypsin (AT) deficiency. Bilateral targeted lower lobe stapled LVRS using video thoracoscopy was performed in six patients (five males) aged 61+/-9 yrs (mean+/-SD) with alpha1-AT emphysema. Two patients received only a 6-month follow-up. However, four patients, at 22, 24, 27 and 36 months post-LVRS, noted relief from dyspnoea and increased walk tolerance. At 27+/-6 months (mean+/-SD) post-LVRS, their forced expiratory volume in one second improved only from 30+/-2\% of the predicted value (mean+/-SEM) before surgery to 33+/-1\% pred after surgery. Yet, total lung capacity (TLC) decreased from 151+/-13 to 127+/-10\% pred; diffusing capacity increased from 35+/-9 to 59+/-9\% pred; and vital capacity increased from 68+/-10 to 88+/-5\% pred. In three patients, static lung elastic recoil at TLC increased from 1.1+/-0.15 to 1.2+/-0.10 kPa. Using flow/pressure curves, the mechanism for expiratory airflow limitation pre-LVRS and the improvement noted post-LVRS could be primarily accounted for by the initial loss and subsequent increase in lung elastic recoil. Bilateral lung volume reduction surgery provides modest physiologic improvement for 2-3 yrs in patients with alpha1-antitrypsin emphysema due to increases in lung elastic recoil.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/14/4/928}, eprint = {https://erj.ersjournals.com/content/14/4/928.full.pdf}, journal = {European Respiratory Journal} }