Correlation of unilateral thoracoscopic lung volume reduction with improvement in lung function and exercise performance in patients with severe pulmonary emphysema

Abstract

This study was conducted to investigate the correlation of thoracoscopic lung volume reduction to changes in pulmonary function and exercise performance in patients with pulmonary emphysema. Unilateral thoracoscopic lung volume reduction treatment was performed in 30 patients with severe pulmonary emphysema. If large bullae were present, they were excised using an endoscopic stapling device, and the emphysematous pleura was contracted by neodymium:yttrium-aluminium-garnet laser to reduce the volume of nonfunctional lung air space. Pulmonary function and incremental exercise tests were performed before and at least 3 months after treatment. Follow-up functional evaluation showed a highly significant improvement in the forced expiratory volume in 1s (FEV1), forced vital capacity, static compliance, and maximal oxygen uptake. The functional residual capacity as measured by the gas dilution method (FRCgas), was unchanged; however, it was found to be decreased significantly when measured by body plethysmograph (FRCbox). Positive correlations existed between the reduction in FRCbox and the increase in FEV1 (r = 0.586, P = 0.0042) and maximal oxygen uptake (r = 0.550, P = 0.018). Pulmonary ventilation and exercise ability in patients with pulmonary emphysema were improved in a volume-dependent manner by thoracoscopic lung volume reduction. These findings indicate that patients with a preoperative trapped gas volume level exceeding 11 would be ideal candidates for thoracoscopic lung volume reduction.

Improved activities of daily living, psychological state and health‐related quality of life for 12 months following lung volume reduction surgery in patients with severe emphysema

“…Between October 1996 and May 1999, 18 male patients with severe emphysema aged 65.2 ± 6.4 years (mean ± SD) underwent LVRS by video‐assisted thoracoscopic surgery using staple resection at the Tohoku University Hospital (LVRS group) 11,12 . Each patient underwent bilateral simultaneous procedures.…”

Effects of Lung Volume Reduction Surgery for Emphysema on Oxygen Cost of Breathinga

“…Twenty-three patients who fulfilled the previously published inclusion and exclusion criteria for LVRS 13,14 were selected in this study. Patients with giant bullae were excluded.…”