Long-Term Beneficial Effects of Lung Volume Reduction Surgery on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation, which results in exertional dyspnea and physical disability. Subsequently, those cause a difficulty in performing routine activities of daily living and affect their health-related quality of life (HRQOL). Lung volume reduction surgery (LVRS) has been reported to be an effective treatment for selected patients with advanced COPD to improve pulmonary function, lung mechanics, exercise tolerance, and dyspnea. However, the long-term effects of LVRS on HRQOL have not been fully investigated. Therefore the effects of LVRS on generic and disease-specific HRQOL were assessed in patients with COPD following LVRS for 36 months. Nineteen patients (65.1 ± 7.0 [mean ± S.D.] years old) who underwent pulmonary rehabilitation plus LVRS (LVRS group), and 8 patients (67.2 ± 5.8 years old) who did pulmonary rehabilitation but not LVRS (Medical group) were studied. In both groups, optimal medication was given throughout this period. Generic HRQOL and diseasespecific HRQOL were evaluated before rehabilitation, and 3, 12, 24, and 36 months after LVRS. Following LVRS, the generic HRQOL was significantly improved and the diseasespecific HRQOL was maintained up to 36 months. In Medical group, disease-specific HRQOL rapidly deteriorated. In conclusion, the long-term effects of LVRS on HRQOL in COPD patients were maintained up to 36 months compared with Medical group. Both generic and disease-specific HRQOL changed differently, suggesting the importance of both assessments especially in long-term follow up.sickness impact profile; visual analogue scale; rehabilitation; lung volume reduction surgery; quality of life © 2007 Tohoku University Medical PressChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. The prevalence of COPD was 3.6% in all Japanese subjects (Takemura et al. 2005) and at least 8.6% in the general Japanese population aged over 40 years (Fukuchi et al. 2004); males in their 50s and over 60 years old and females over 60 years old showed remarkably

Clinical Observation of General Anesthesia Combined with Spinal Anesthesia in Elderly Patients with Chronic Obstructive Pulmonary Disease

“…Therefore, it is very important to choose anesthesia methods for patients. GA combined with SA is regarded as a very effective perioperative management method for high-risk patients with large surgical trauma [ 11 ]. Studies have confirmed that GA combined with SA is more effective than GA alone, and it is more suitable for thoracic and upper abdominal surgery in elderly patients [ 12 , 13 ].…”