Lung volume reduction surgery: lessons learned.
BACKGROUND
The concept of lung volume reduction for generalized emphysema was proposed by Brantigan and associates in 1958 and reintroduced by Cooper and colleagues in 1994. The present study presents lessons learned from an 18-month experience.


METHODS
From August 1, 1994, to August 1, 1995, 53 patients underwent lung volume reduction at Emory University for generalized emphysema. There were 17 women and 36 men ranging in age from 55 to 75 years. The length of stay ranged from 10 to 59 days. At the time of presentation, 47 patients were receiving oxygen and 35 were receiving steroids. Forty-six patients were operated on using a median sternotomy and 7 through a unilateral thoracotomy. All patients underwent preoperative and postoperative pulmonary rehabilitation.


RESULTS
There was one early death and four late deaths. Lessons learned from this group of patients are presented.


CONCLUSIONS
Lung volume reduction surgery remains a sea of relatively uncharted waters, with the future direction yet to be determined.
Miller
J I
JI
Division of General Thoracic Surgery, Emory University School of Medicine, Atlanta, GA 30308, USA.
Lee
R B
RB
Mansour
K A
KA
D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011013:Pneumonectomy / Q000379:methods; D011182:Postoperative Care; D011183:Postoperative Complications; D011656:Pulmonary Emphysema / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome