Lung reduction surgery for emphysema.
Lung reduction surgery, a procedure that entails removal of portions of the most diseased lung tissue in patients with diffuse emphysema, has been resurrected based on advances in surgical technique, radiographic imaging, and pulmonary physiologic assessment. We outline potential mechanisms for improvement in pulmonary mechanics, gas exchange, pulmonary vascular function, and exercise tolerance following surgery. Available literature is reviewed, and patterns that are beginning to emerge with respect to optimal surgical approach and patient selection criteria are presented. Early results suggest that this procedure offers real hope to our patients; however, long-term follow-up studies will be necessary to define its ultimate utility.
Sciurba
F C
FC
Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, PA 15213, USA.
Rogers
R M
RM
D017079:Exercise Tolerance / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D018579:Patient Selection; D011013:Pneumonectomy / Q000009:adverse effects / Q000145:classification / Q000379:methods*; D011652:Pulmonary Circulation / Q000502:physiology; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D011859:Radiography; D015656:Respiratory Mechanics / Q000502:physiology; D016896:Treatment Outcome