[Bilateral surgical lung volume reduction in severe emphysema].
OBJECTIVE
To report preliminary results with a new surgical method of treating terminal emphysema by bilateral reduction of lung volume.


METHODS
In a prospective study, the results obtained with the first 20 consecutive patients (mean FEV1: 590 +/- 180 ml) who underwent operative reduction of lung volume were recorded. 19 of the 20 patients had required continuous oxygen supply.


RESULTS
The patients were extubated 8.5 +/- 6 h postoperatively; thoracic drainage was removed after 9 +/- 6 days. The degree of dyspnoea was decreased in all patients (3.5 +/- 0.5 vs 0.5 +/- 0.1). Significant reduction of overinflation occurred soon after the operation (residual volume 273 +/- 125 to 201 +/- 107% of normal; total capacity from 142 +/- 18 to 109 +/- 22% of normal), as well as reduction in the degree of obstruction (FEV1 from 18 +/- 6 to 24 +/- 7% of normal; for each, P < 0.05). One patient died 3 weeks post-operatively of Candida infection.


CONCLUSIONS
The method looks promising for the treatment of selected patients and may thus provide an alternative to lung transplantation.
Demertzis
S
S
Klinik für Thorax-, Herz- und Gefässchirurgie, Medizinische Hochschule Hannover.
Schäfers
H J
HJ
Wagner
T O
TO
Hausen
B
B
Fabel
H
H
Borst
H G
HG
D000328:Adult; D004417:Dyspnea / Q000517:prevention & control; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D011446:Prospective Studies; D011656:Pulmonary Emphysema / Q000503:physiopathology / Q000601:surgery*; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000517:prevention & control; D013997:Time Factors
Bilaterale Lungenvolumenreduktion bei schwerem Emphysem.