Longitudinal changes in hyperinflation parameters and exercise capacity after giant bullous emphysema surgery.
OBJECTIVE
Although resection of giant bullae for the purpose of improving the function of underlying compressed lung is an accepted form of surgery for emphysema, there is only limited information regarding long-term improvement in dynamic hyperinflation and exercise tolerance. Our major goal was to investigate the effects of lung resection for giant bullae on pulmonary function, dynamic hyperinflation, and exercise capacity in patients with chronic obstructive pulmonary disease characterized by emphysema.


METHODS
Pulmonary function and exercise testing were assessed prospectively before and 3, 6, 12, 24, and 48 months after surgery in 12 patients who had chronic obstructive pulmonary disease with emphysema who underwent lung resection of giant bullae.


RESULTS
Forced expiratory volume, diffusing capacity for carbon monoxide, arterial partial pressure of oxygen, and exercise capacity were significantly increased after resection of surgical bullae. Dynamic hyperinflation, as assessed by reduction in inspiratory capacity and dyspnea Borg scale, were significantly decreased during exercise. Improvement in baseline and exercise functional capacity slightly decreased over time, remaining, however, far above the value before surgery.


CONCLUSIONS
Altogether, these findings suggest that surgery for resection of giant bullae is an effective procedure for improving airflow, limiting gas exchange, and limiting exercise dynamic hyperinflation over time.
Neviere
Rémi
R
Explorations Fonctionnelles Respiratoires, Hôpital Calmette, CRHU Lille, France. rneviere@univ-lille2.fr
Catto
Michèle
M
Bautin
Nathalie
N
Robin
Sophie
S
Porte
Henri
H
Desbordes
Jacques
J
Matran
Régis
R
D000368:Aged; D004417:Dyspnea / Q000209:etiology; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D011656:Pulmonary Emphysema / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D011659:Pulmonary Gas Exchange; D012129:Respiratory Function Tests