title: Results of lung volume reduction surgery in patients with emphysema. The Washington University Emphysema Surgery Group.
abstract: Between January 1993 and April 1995, 84 patients with emphysema underwent bilateral lung volume reduction surgery at Barnes Hospital, Fifty-three patients had completed 3 months; 37 patients, 6 months; and 19 patients, 1 year of follow-up. Significant improvement was observed in spirometric parameters, oxygenation, 6-minute walking distance, dyspnea indices, and quality-of-life scores. The average increases in FEV1 were 52%, 51%, and 61%, at 3,6, and 12 months, respectively, after surgery. The most common postoperative complication, prolonged ( > 7 days) chest tube drainage, was present in 63% of the cases, and the mean duration of hospitalization in the survivors was 15 days (range 5 to 49 days). This has been reduced to 11 days (median 7.5 days) for the subsequent 40 patients. Five postoperative deaths occurred, 2 in the first, 2 in the third, and 1 in the fifth postoperative month, respectively. The overall mortality in the 84 patients was 6%, and the actuarial survival at 1 year was 93%. Volume reduction surgery is a promising therapeutic option for patients with an appropriate pattern of emphysema. Improvement has been sustained for more than 1 year, and long-term follow-up is planned to ascertain the duration of the benefits.
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Yusen
authors.forename: E P
authors.initials: EP
authors.lastname: Trulock
authors.forename: M S
authors.initials: MS
authors.lastname: Pohl
authors.forename: D G
authors.initials: DG
authors.lastname: Biggar
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D011656:Pulmonary Emphysema / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D015996:Survival Rate