Effect of bilateral lung volume reduction surgery on FEV1 decline in severe emphysema.
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.
Travaline
John M
JM
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
Gaughan
John P
JP
Furukawa
Satoshi
S
Criner
Gerard J
GJ
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