Lung Volume Reduction Surgery

Daniel, Thomas M.; Chan, Barry; Bhaskar, Varun; Parekh, Jayashree S.; Walters, Peggie E.; Reeder, Jo; Truwit, Jonathon D.

doi:10.1097/00000658-199605000-00008

Cited by 86 publications

(2 citation statements)

References 4 publications

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“…1,7,8 In many reported series, patients with resting hypercapnia were excluded as candidates. 2,3,5,6,15,16 Other investigators have reported low mortality and significant improvements in lung function, 6-min walk distance, and dyspnea index among patients who underwent LVRS with a preoperative Paco 2 of Ն 55 mm Hg. 17 However, improvements in lung volumes, cardiopulmonary exercise performance, or gas exchange were not reported.…”

Section: Discussionmentioning

confidence: 98%

Improvements in Lung Function, Exercise, and Quality of Life in Hypercapnic COPD Patients After Lung Volume Reduction Surgery

O’Brien

Furukawa

Kuzma

et al. 1999

Chest

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Section: Discussionmentioning

confidence: 98%

Improvements in Lung Function, Exercise, and Quality of Life in Hypercapnic COPD Patients After Lung Volume Reduction Surgery

O’Brien

Furukawa

Kuzma

et al. 1999

Chest

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“…It should be emphasized that the results of these studies are somewhat difficult to interpret since selection criteria used for patient enrolment and the surgical techniques employed varied from centre to centre. In the vast majority of studies, however, an improvement in FEV 1 and VC after LVRS was clearly demonstrable [18, 28, 29, 30, 31]. TLC and RV values have also been reported to be consistently reduced by LVRS [18, 31], documenting a reduction in the degree of lung hyperinflation.…”

Section: Lvrs For Emphysemamentioning

confidence: 99%

Management of COPD: Surgical Options

Palange

2001

Respiration

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Dyspnoea on exertion and exercise intolerance are the hallmarks of chronic obstructive pulmonary disease (COPD); the primary causes appear to be respectively, increased airway resistance with reduced maximal ventilatory capacity and peripheral skeletal muscle dysfunction with early onset of anaerobic metabolism. Patients with end-stage COPD usually show little or no benefit from conventional medical treatment. Physical training is capable of ameliorating exercise tolerance, but improvement is usually modest in the advanced disease state. Two surgical options are generally accepted for carefully selected patients with emphysema: resection of large bullae, when identified, and lung transplantation. Transplantation, the only effective cure for advanced COPD, is of limited use primarily because of age, comorbidity, limited availability of organs and cost. A different approach for severe emphysema, lung volume reduction surgery (LVRS), has been increasingly utilized during the past several years. In carefully selected emphysematous patients, LVRS improves lung volumes and mechanics, and reduces exertional dyspnoea. Unfortunately, surgical mortality still remains high and some patients show no measurable improvement after surgery. There is an urgent need for data on long-term effects of LVRS; the results of large, randomized trials will soon be forthcoming. The aim of this brief review is to summarize the available knowledge on the effects of LVRS, the criteria for patient selection, short- versus long-term effects and, finally, to propose future directions in this field.

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