title: Active management of a patient with endstage pulmonary emphysema using lung volume reduction surgery and intensive rehabilitation.
abstract: BACKGROUND
  Lung volume reduction surgery (LVRS) and pulmonary rehabilitation are newer options available in the treatment of advanced emphysema. We describe the progress of our first local patient to have undergone these 2 new treatment modalities.
  
  
  METHODS
  A 65-year-old man with advanced emphysema, limited by crippling dyspnoea despite maximal medical therapy with inhaled bronchodilator therapy, methylxanthines and supplementary oxygen.
  
  
  METHODS
  Physical reconditioning with a 4-week inpatient pulmonary rehabilitation programme, followed by LVRS and a further 6-week outpatient pulmonary rehabilitation.
  
  
  RESULTS
  Dramatic improvements in spirometric indices, arterial blood gases, exercise capacity and overall functional status. Improvements maintained at one-year follow up period.
  
  
  CONCLUSIONS
  LVRS with pulmonary rehabilitation is an exciting new treatment option in a select group of patients with advanced emphysema. Their role in improving overall performance status and quality of life should be considered in patients otherwise considered to have reached the limits of medical therapy.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
authors.forename: C P
authors.initials: CP
authors.lastname: Lo
authors.forename: K C
authors.initials: KC
authors.lastname: Ong
authors.forename: T Y
authors.initials: TY
authors.lastname: Yang
authors.forename: T
authors.initials: T
authors.lastname: Agasthian
authors.forename: Y Y
authors.initials: YY
authors.lastname: Ong
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000503:physiopathology / Q000534:rehabilitation; D005081:Exercise Therapy; D006801:Humans; D008297:Male; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000534:rehabilitation / Q000601:surgery*