Lung Volume Reduction in Patients With Severe Diffuse Emphysema

Roué, C; Mal, Hervé; Sleiman, C; Fournier, Michel; Duchatelle, J P; Baldeyrou, P; Parienté, R

doi:10.1378/chest.110.1.28

Cited by 61 publications

(32 citation statements)

References 18 publications

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“…[1][2][3] 1990'lı yıllara kadar komplikasyonsuz heterojen amfizemli hastalarda cerrahi tedavinin yeri tartışmalı idi. Fakat son yıllarda hacim küçültücü ameliyat olarak bilinen cerrahi teknik yaygınlık kazanmasına rağmen, [5][6][7][8][9][10] pratikte uygulanması yüksek ameliyat sonrası morbiditeye neden olabileceğinden doğru hasta seçimi önemlidir.…”

Section: Discussionunclassified

Comparative results of surgical treatment of bullous lung diseases complicated with pneumothorax and the use of polytetrafluoroethylene graft support

Şengül¹

2013

Turk Gogus Kalp Dama

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Amaç: Büllöz akciğer hastalıklarında politetrafloroetilen (PTFE) greft kullanımının komplikasyonları azaltmadaki etkinliği araştırıldı. Ça lış ma pla nı: Ocak 2004 -Aralık 2012 tarihleri arasında spontan pnömotoraks ile komplike olmuş büllöz akciğer hastalığı olan 22 hasta çalışmaya alındı. Hastalar iki gruba ayrıldı. Grup 1'de 10 hastada heterojen amfizematöz hastalık, grup 2'de ise 12 hastada homojen amfizematöz hastalık vardı. Her iki gruba da kas korumalı torakotomi yapıldı. Stapler kullanılarak kama rezeksiyon uygulandı. Grup 1'de altı, grup 2'de beş hastanın rezeksiyon hattı genişleyebilen PTFE greft ile desteklendi. Tedavi sonuçları ve komplikasyonlar gruplar arasında karşılaştırıldı. Bul gu lar: Tedavi sonucunu belirleyen en önemli kriter amfizemin alt tipi idi. Her iki amfizem alt tipi için PTFE greft destek kullanımının komplikasyonlar üze-rine etkisi görülmemesine karşılık, bunun göğüs tüpü çekilme süresini ve hastanede kalış süresini kısalttığı görüldü. So nuç: Tedavi sonucunu belirleyen en önemli kriterin amfizem alt tipi olduğu, her iki amfizem alt tipi için PTFE destek kullanımının komplikasyonlar üzerine etkisi görülmemesine karşılık, göğüs tüpü çekilme süresini ve hastanede kalış süresini kısalttığı görüldü.Anah tar söz cük ler: Büllöz akciğer; pnömotoraks; politetrafloroetilen greft.

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Section: Discussionunclassified

Comparative results of surgical treatment of bullous lung diseases complicated with pneumothorax and the use of polytetrafluoroethylene graft support

Şengül¹

2013

Turk Gogus Kalp Dama

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“…Indeed, arterial oxygen tension (Pa,O 2 ) increased in all studies reporting this variable [4, 39, 41±45, 48, 50, 52±54, 56±58, 67, 68], although the improvement was only statistically significant in half of the studies [42,45,48,50,53,56,58,68]. Similarly, arterial carbon dioxide tension (Pa,CO 2 ) either showed a tendency to decrease [4,39,43,44,48,52,53,56,58] or a statistically significant decrease [41,42,45,54,57,67,68].…”

Section: Pathophysiological Basis Of Functional Impairment In Emphysemamentioning

confidence: 99%

“…By way of contrast, O'DONNELL et al [53] did not find any improvement in V 'O 2 ,max in a heterogeneous group of patients, despite postoperative rehabilitation. Dyspnoea, evaluated by variable means, has also been shown to decrease after LVRS [39±43, 45,47,48,50,51,53,54,56,57,60,69].…”

Section: Pathophysiological Basis Of Functional Impairment In Emphysemamentioning

confidence: 99%

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Physiological basis of improvement after lung volume reduction surgery for severe emphysema: where are we?

Marchand¹,

Gayan‐Ramirez²,

Leyn³

et al. 1999

Eur Respir J

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Physiological basis of improvement after lung volume reduction surgery for severe emphysema: where are we? E. Marchand, G. Gayan-Ramirez, P. De Leyn, M. Decramer. #ERJ Journals Ltd 1999. ABSTRACT: Lung volume reduction surgery has become an accepted therapeutic option to relieve the symptoms of selected patients with severe emphysema. In a majority of these patients, it causes objective as well as subjective functional improvement. A proper understanding of the physiological determinants underlying these beneficial effects appears very important in order to better select patients for the procedure that is currently largely carried out on an empirical basis.Lung volume reduction surgery has two distinct effects. Firstly, it causes an increased elastic recoil, which at least partially explains the enhanced maximal expiratory flow. Secondly, it is associated with a reduction of hyperinflation which allows for an increase in global inspiratory muscle strength and in diaphragmatic contribution to tidal volume as well as a decrease in the inspiratory elastic load imposed by the chest wall. Taken together, these effects result in a reduced work of breathing and in an enhanced maximal ventilation which both contribute to the increased exercise capacity and reduced dyspnoea after surgery. The improved lung recoil and the reduced hyperinflation after volume reduction surgery were the primary postulates upon which the usual selection criteria for the procedure were based. It is now likely that these are correct. Nevertheless, some patients do not benefit from lung volume reduction surgery and the current literature does not allow for a refinement of the selection process from a physiological point of view.The exact mechanisms underlying the improvement in lung recoil, lung mechanics, and respiratory muscle function remain incompletely understood. Moreover, the effects of lung volume reduction surgery on gas exchange and pulmonary haemodynamics still need to be more fully investigated. An analysis of the characteristics of patients who do not benefit from the procedure and the development of an animal model for lung volume reduction surgery would probably help address these important issues. Eur Respir J 1999; 13: 686±696.

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“…There are some reports that surgical treatment is to be considered when infections cannot be controlled or repeated to patients with diffuse emphysema [5]. Lung volume reduction surgery (LVRS) is predicated upon the principle that a reduction in lung volume can favorably affect the mechanics of diaphragm, chest wall and airways.…”

Section: Case Reportmentioning

confidence: 99%

Swyer-James Syndrome: Disappearance of Gigantic Bullae and Pulmonary Function Improvement After Infectious Episode

Kim¹,

Ahn²

2012

J Med Cases

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Swyer-James syndrome is an acquired pulmonary disease following bronchiolitis obliterans in young aged children, in which characteristic unilateral hyperlucence radiologically. Frequently there are repeated pulmonary infections which cause bacterial pneumonia and bronchiectasis. It is reported no definite cause of the disease is revealed but in most cases it is thought to be inflammation and destruction of bronchioles after severe pneumonia, and it is related to measles, pertussis, tuberculosis, adenovirus, mycoplasma pneumonia, foreign body aspiration and radiation therapy. Mostly it is diagnosed at early childhood, however the detection can be delayed until later ages in asymptomatic ones. Swyer-James syndrome is a very rare disease and furthermore it is much rare to be detected in adults. Here we report a case of the disappearance of pre-existing gigantic bullae and improvement of pulmonary function in patient having Swyer-James syndrome of 65-year-old male after recovery from infected bullae with relevant literature reviews.

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Lung Volume Reduction in Patients With Severe Diffuse Emphysema

Cited by 61 publications

References 18 publications

Comparative results of surgical treatment of bullous lung diseases complicated with pneumothorax and the use of polytetrafluoroethylene graft support

Comparative results of surgical treatment of bullous lung diseases complicated with pneumothorax and the use of polytetrafluoroethylene graft support

Physiological basis of improvement after lung volume reduction surgery for severe emphysema: where are we?

Swyer-James Syndrome: Disappearance of Gigantic Bullae and Pulmonary Function Improvement After Infectious Episode

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