title: Unilateral thoracoscopic reduction pneumoplasty for asymmetric emphysema.
abstract: OBJECTIVE
  We prospectively analyzed the surgical and functional results of unilateral thoracoscopic reduction pneumoplasty which we performed by choice in patients with asymmetric emphysema.
  
  
  METHODS
  Between October 1995 and June 1997, 119 emphysematous patients were examined and 34 were operated upon. Among these, 14 selected patients with asymmetric distribution of emphysema in the lungs underwent unilateral reduction pneumoplasty (ten right, and four left). There were 13 males and one female, with a mean age of 62 years. Eligibility criteria included bullous and non-bullous end-stage emphysema with severe limitation to daily activity.
  
  
  RESULTS
  No patient required conversion to thoracotomy. Mean operative time ranged between 70 and 240 min with a mean of 103 min. There was no postoperative mortality but five patients developed one or more complications: five prolonged air leaks (>7 days); two pulmonary infections; one empyema. No patient required postoperative mechanical ventilation. Median hospital stay was 8 days. At the 3-month follow-up the mean FEV1 increased from 0.8 l to 1.2 l (P < 0.001). Mean FVC increased from 2.6 l to 2.9 l (P < 0.001). The Medical Research Council dyspnea score decreased from a mean of 3.2 to 1.8 (P < 0.001).
  
  
  CONCLUSIONS
  Asymmetric distribution is a frequent finding in patients with severe emphysema. Unilateral thoracoscopic reduction pneumoplasty may represent an ideal approach in this selected group of patients.
authors.affiliation: Department of Thoracic Surgery, Tor Vergata University, Rome, Italy. mineo@utovrm.it
authors.forename: T C
authors.initials: TC
authors.lastname: Mineo
authors.forename: E
authors.initials: E
authors.lastname: Pompeo
authors.forename: G
authors.initials: G
authors.lastname: Simonetti
authors.forename: A F
authors.initials: AF
authors.lastname: Sabato
authors.forename: F
authors.initials: F
authors.lastname: Turani
authors.forename: P
authors.initials: P
authors.lastname: Rogliani
authors.forename: F
authors.initials: F
authors.lastname: De Padova
authors.forename: I
authors.initials: I
authors.lastname: Nofroni
mesh_terms: D000368:Aged; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011446:Prospective Studies; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000601:surgery*; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome