[Safety and effectiveness of lung volume reduction surgery for treatment of chronic obstructive pulmonary disease].
Lung volume reduction surgery (LVRS) has been proposed and performed in order to decrease dyspnea and improve wordly life without major impairments in oxygen-dependent patients affected by serious chronic obstructive pulmonary disease (COPD) and severe dyspnea that doesn't suffer drastic alterations notwithstanding rehabilitation procedures tailored for the specific case. The purpose of LVRS is to optmize thoraco-pulmonary dynamics, considerably compromised in these patients, relaxing the serious expiratory restraint to airflow and improving the muscular respiratory functionality. In this work the authors bring forth the physio-pathological foundations that justify the use of LVRS, also analyzing data brought by the international literature about surgery guidelines, short-term morbidity and mortality, clinical-functional effects and long-term survival. They also underline the need for careful evaluation research, aimed at getting a precise account of cardio-respiratory functional outcome, that will enable the positive accomplishement of the demanding and risky surgery, especially whenever the pathology has reached remarkable proportions or appears to be bilaterally localized. Only committing to painstaking analysis, setting and customization protocols, the latter especially addressing carefully chosen patients, can the surgeon rely on to achieve both short and long-term positive outcomes.
Barresi
P
P
Università degli Studi di Messina, Azienda Ospedaliera Universitaria G. Martino, Dipartimento di Scienze Cardiovascolari e Toraciche Cattedra ed U.O.C. di Chirurgia Toracica.
Mondello
B
B
Barone
M
M
Pavia
R
R
D006801:Humans; D011013:Pneumonectomy / Q000009:adverse effects; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000601:surgery*; D011656:Pulmonary Emphysema / Q000150:complications / Q000601:surgery