Thoracoscopic carbon dioxide laser treatment of bullous emphysema

Abstract

A new technique of thoracoscopic laser ablation of pulmonary bullae suitable for patients with multiple bullae and diffuse emphysema was developed and assessed in 22 patients. 20 of 22 patients survived. Pre-operative and postoperative functional evaluation is available for the 11 patients followed up for more than a month; at 1 to 3 months postoperatively there were increases in FVC (mean 2.0 litres pre-operatively to 2.7 litres postoperatively, p less than 0.001), in FEV1 (0.74 to 1.06 litres, p = 0.01), and in maximum exercise treadmill times (5.4 min to 8.0 min, p less than 0.01). Postoperative air leaks lasted a mean of 13 days and usually resolved spontaneously. Other complications were bleeding (1 patient) and unilateral acute lung injury (1 patient). These results suggest that selected patients with diffuse emphysema and pulmonary bullae may benefit from thoracoscopic carbon dioxide laser ablation.

The Role of NETT in Emphysema Research

“…He had a 10% early mortality, but survivors had a 35% increase in vital capacity, and a 43% increase in FEV 1 (14). He had similar, though less impressive, results in his next 500 cases (15).…”

Video-assisted thoracoscopic laser ablation in the treatment of primary spontaneous pneumothorax

“…The first clinical series of laser ablation was reported by Wakabayashi et al [18] in 1991. In their study, carbon dioxide (CO 2 ) laser ablation via thoracoscopy was used for 22 patients with multiple bullae or diffuse emphysema.…”

Respiratory diseases

“…It is certainly being used for carbon dioxide laser treatment of bullous emphysema in California. 3 Patients had advanced emphysema with severe pulmonary dysfunction and were too high a risk for conventional surgical bullectomy. In this study, there was significant objective improvement, which has persisted.…”