Lung Volume Reduction Surgery and Pulmonary Rehabilitation Improve Exercise Capacity and Reduce Dyspnea During Functional Activities in People with Emphysema

Beling, Janna

doi:10.1097/01823246-200920020-00002

Cited by 5 publications

(1 citation statement)

References 52 publications

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“…This encompasses endobronchial placement of valves (EBV-LVR) or minimally invasive keyhole surgery, such as robot-assisted LVR surgery (RATS-LVRS) or video-assisted LVRS (VATS-LVRS). Surgical LVR is an effective, established treatment for selected patients with severe emphysema and has been shown to provide improvements in health status and lung function outcomes [50][51][52].…”

Section: Lung Volume Reduction Proceduresmentioning

confidence: 99%

Caring for patients with advanced COPD: beyond the inhalers…

Murray,

Mulryan,

Ní Chléirigh

et al. 2023

Breathe

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COPD affects millions of people worldwide. Patients with advanced COPD have a high symptom burden. Breathlessness, cough and fatigue are frequent daily symptoms. Guidelines often focus on pharmacological treatment, especially inhaler therapy, but other approaches in combination with medications offer symptomatic benefit.In this review, we take a multidisciplinary approach with contributions from pulmonary physicians, cardiothoracic surgeons and a physiotherapist. The following areas are addressed: oxygen therapy and noninvasive ventilation (NIV), dyspnoea management, surgical and bronchoscopic options, lung transplantation and palliative care. Oxygen therapy prescribed within guidelines improves mortality in patients with COPD. NIV guidelines offer only low-certainty instruction on the use of this therapy on the basis of the limited available evidence. Dyspnoea management can take place through pulmonary rehabilitation. Specific criteria aid decisions on referral for lung volume reduction treatments through surgical or bronchoscopic approaches. Lung transplantation requires precise disease severity assessment to determine which patients have the most urgent need for lung transplantation and are likely to have the longest survival. The palliative approach runs in parallel with these other treatments, focusing on symptoms and aiming to improve the quality of life of patients and their families facing the problems associated with life-threatening illness. In combination with appropriate medication and an individual approach to symptom management, patients' experiences can be optimised.Educational aimsTo understand the multidisciplinary approach to management of patients with advanced COPD.To recognise the parallel approaches to oxygen, NIV and dyspnoea management with consideration of more interventional options with lung volume reduction therapy or lung transplantation.To understand the high level of symptomatology present in advanced COPD and the relevance of palliative care alongside optimal medical management.

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Section: Lung Volume Reduction Proceduresmentioning

confidence: 99%

Caring for patients with advanced COPD: beyond the inhalers…

Murray,

Mulryan,

Ní Chléirigh

et al. 2023

Breathe

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Kinesiterapia perioperatoria en cirugía torácica pulmonar

Freynet

Sarreau

Gracia

et al. 2021

EMC - Kinesiterapia - Medicina Física

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Lung volume reduction surgery: a micro-costing analysis from a national tertiary referral centre

Mulryan,

Sorensen,

Waller

et al. 2024

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Lung volume reduction surgery (LVRS) is a clinically effective palliation procedure for patients with chronic obstructive pulmonary disease (COPD). LVRS has recently been commissioned by the NHS England. In this study, a costing model was developed to analyse cost and resource implications of different LVRS procedures. METHODS Three pathways were defined by their surgical procedures: bronchoscopic endobronchial valve insertion (EBV-LVRS), video assisted (VATS-LVRS), and robotic assisted LVRS (RATS-LVRS). The costing model considered use of hospital resources from the LVRS decision until 90-days after hospital admission. The model was calibrated with data obtained from an observational study, electronic health records, and expert opinion. Unit costs were obtained from the hospital finance department and reported in 2021-Euros. RESULTS VATS-LVRS was associated with the lowest cost at €12,896 per patient. This compares to the costs of EBV-LVRS at €15,598 per patient and €13,305 per patient for RATS-LVRS. A large component of EBV-LVRS costs were accrued secondary to complications, including revision EBV-LVRS. CONCLUSIONS This study presents a comprehensive model framework for the analysis of hospital-related resource use and costs for the three surgical modalities. In the future, service commissioning agencies, hospital management, and clinicians can use this framework to determine their modifiable resource use (composition of surgical teams, use of staff and consumables, planned length of stay, and revision rates for EBV-LVRS) and to assess the potential cost implications of changes in these parameters.

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Lung Volume Reduction Surgery and Pulmonary Rehabilitation Improve Exercise Capacity and Reduce Dyspnea During Functional Activities in People with Emphysema

Cited by 5 publications

References 52 publications

Caring for patients with advanced COPD: beyond the inhalers…

Caring for patients with advanced COPD: beyond the inhalers…

Kinesiterapia perioperatoria en cirugía torácica pulmonar

Lung volume reduction surgery: a micro-costing analysis from a national tertiary referral centre

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