title: Effect of bilateral lung volume reduction surgery on FEV1 decline in severe emphysema.
abstract: OBJECTIVE
  To examine whether lung volume reduction surgery (LVRS) alters the anticipated natural rates of decline in FEV1.
  
  
  METHODS
  Retrospective analysis of spirometry results (188 studies) in patients before and after bilateral LVRS. Setting. Large, urban, academic medical center.
  
  
  METHODS
  25 patients with severe emphysema (mean (SD) age 60+/-8 yrs; FEV1 0.74+/-0.29 L, 29% predicted).
  
  
  METHODS
  Bilateral LVRS performed via median sternotomy, with areas targeted for resection based on preoperative evaluation using high-resolution computed tomography, quantitative perfusion scans, and intraoperative inspection of the lungs. Linear regression analysis was performed on each patient using all serial postbronchodilator FEV1 values from before and after LVRS.
  
  
  RESULTS
  Lung function data were available between 2-1001 days prior to LVRS and 71-1169 days after LVRS. Comparison of single pre- and post-LVRS FEV1 results confirmed a significant post-operative (3 month) improvement in lung function. The calculated rate of decline in FEV1 prior to LVRS was 202+/-205 mL/yr. Following LVRS, the rate of decline in FEV1 was unchanged at 178+/-150 mL/yr (p = 0.64).
  
  
  CONCLUSIONS
  In patients with severe emphysema, bilateral LVRS does not appear to significantly alter the rate of FEV1 decline.
authors.affiliation: Division of Pulmonary and Critical Care Medicine and Cardiothoracic Surgery, Temple University School of Medicine, 3401 North Broad St., Philadelphia, Pennsylvania 19140, USA. travaljm@tuhs.temple.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Travaline
authors.forename: John P
authors.initials: JP
authors.lastname: Gaughan
authors.forename: Satoshi
authors.initials: S
authors.lastname: Furukawa
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Criner
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000503:physiopathology* / Q000601:surgery*; D012189:Retrospective Studies; D013147:Spirometry; D016896:Treatment Outcome