Rate of FEV1 Change Following Lung Volume Reduction Surgery

Brenner, Matthew; McKenna, Robert J.; Gelb, Arthur F.; Fischel, Richard; Wilson, Archie F.

doi:10.1378/chest.113.3.652

Cited by 93 publications

(54 citation statements)

References 12 publications

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“…This value is similar to that reported by Brenner and coworkers [7] in patients undergoing unilateral procedures and is somewhat less than that reported by Traveline and coworkers [14] after bilateral one-stage operations.…”

Section: Commentsupporting

confidence: 90%

“…However, due to the chronic and progressive nature of emphysema, postoperative improvements usually peak within the first 6 to 12 months and slowly decline subsequently, eventually returning back to the baseline status in many patients [5][6][7]. Optimal nonsurgical management of these patients is difficult owing to their poor clinical response to pharmacological therapy and is expensive because of the frequent need of outpatient or in-hospital care.…”

Section: Lung Volume Reduction Reoperationsmentioning

confidence: 99%

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Lung Volume Reduction Reoperations

Tacconi

Pompeo

Forcella

et al. 2008

The Annals of Thoracic Surgery

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Background. Optimal management of emphysematous patients who have lost the benefits achieved after lung volume reduction surgery is a clinical dilemma. We have hypothesized that in stringently selected instances, lung volume reduction reoperations might be considered as a salvage surgical treatment. We sought to analyze the results of a series of patients undergoing lung volume reduction reoperations after successful bilateral lung volume reduction surgery.Methods. Between January 2000 and April 2006, 17 patients (mean age, 66 ؎ 3 years) with radiologic evidence of distinct regional lung hyperinflation underwent lung volume reduction reoperations. Surgical procedures entailed completion lobectomy in 7 patients, nonanatomic resection of lung target areas were performed in 5 patients under general anesthesia with one-lung ventilation, and awake lung plication was performed in 5 patients under sole epidural anesthesia. Follow-up at 6 and 12 months was complete in all survivors.Results. Mean operative time was 100 ؎ 12 minutes. Two patients (11.7%) died perioperatively of adult respi-

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Section: Commentsupporting

confidence: 90%

Section: Lung Volume Reduction Reoperationsmentioning

confidence: 99%

Lung Volume Reduction Reoperations

Tacconi

Pompeo

Forcella

et al. 2008

The Annals of Thoracic Surgery

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“…It is very difficult to achieve follow-up at regular repeated intervals in this group of patients [34]. It was not easy to motivate patients to come for follow-up visits over long distances, if no subjective changes had occurred, although great care was taken to keep in contact with patients, at least by telephone, thus not every patient was seen at every follow-up date.…”

Section: Discussionmentioning

confidence: 99%

“…Operative mortality rates have been reported as 0±8%, with higher rates in the most severely affected patients [12,33]. It has been shown that there is a correlation between the magnitude of short-term improvement in FEV1 and the rate of deterioration, with more rapid decline in FEV1 in those patients with the best initial improvement [34]. However, in the present patients, the annual decrease in FEV1 seemed not to be not altered by LVRS, with an identical rate of decline in FEV1 in the surgical and medical treatment groups.…”

Section: Discussionmentioning

confidence: 99%

Lung volume reduction surgery versus conservative treatment in severe emphysema

Wilkens

Demertzis²,

König

et al. 2000

Eur Respir J

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Lung volume reduction surgery (LVRS) has been proposed for patients with severe emphysema to improve dyspnoea and pulmonary function. It is unknown, however, whether prognosis and pulmonary function in these patients can be improved compared to conservative treatment.The effect of LVRS and conservative therapy were compared prospectively in 57 patients with emphysema, who fulfilled the standard criteria for LVRS. The patients were divided into two groups according to their own decision. Patients in group 1 (n=29, eight females, meanSEM 58.81.7 yrs, forced expiratory volume in one second (FEV1) 27.61.3% of the predicted value) underwent LVRS. Patients in group 2 (n=28, five females, 58.51.8 yrs, FEV1 30.81.4% pred) preferred to postpone LVRS. There were no significant differences in lung function between the two groups at baseline; however, there was a tendency towards better functional status in the control group. The control group had a better modified Medical Research Council (MMRC) dyspnea score (3.10.15 versus 3.50.1, p<0.04).Model-based comparisons were used to estimate the differences between the two groups over 18 months. Significant improvements were observed in the LVRS group compared to the control group in FEV1, total lung capacity (TLC), Residual volume (RV), MMRC dyspnea score and 6-min walking distance on all follow up visits. The estimated difference in FEV1 was 33% (95% confidence interval 13±58%; p>0.0001), in TLC 12.9% (7.9±18.8%; p>0.0001), in RV 60.9% 32.6±89.2%; p>0.0001), in 6-min walking distance 230 m (138±322 m; p<0.002) and in MMRC dyspnoea score 1.17 (0.79±1.55; p<0.0001).In conclusion, lung volume reduction surgery is more effective than conservative treatment for the improvement of dyspnoea, lung function and exercise capacity in selected patients with severe emphysema.

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“…One of the reasons may be that COPD is the progressive disease, and it is difficult for COPD patients to expect long lasting beneficial effects of LVRS. Indeed, lung function appears to improve in the first few months following LVRA in most patients, maximizing at approximately 3 to 6 months and declining thereafter (Brenner et al 1998;Goto et al 2004). …”

Section: Discussionmentioning

confidence: 99%

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

Gotö

Kohzuki²,

Meguro³

et al. 2007

Tohoku J. Exp. Med.

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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

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Rate of FEV1 Change Following Lung Volume Reduction Surgery

Cited by 93 publications

References 12 publications

Lung Volume Reduction Reoperations

Lung Volume Reduction Reoperations

Lung volume reduction surgery versus conservative treatment in severe emphysema

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

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