title: Therapeutic application of collateral ventilation with pulmonary drainage in the treatment of diffuse emphysema: report of the first three cases.
abstract: OBJECTIVE
  To report the results obtained in three patients with diffuse pulmonary emphysema during the pre- and post-operative periods following a new surgical technique: collateral ventilation with lung parenchyma drainage.
  
  
  METHODS
  Patients suffering from pulmonary failure and disabling dyspnea, despite having received the gold standard treatment, including pulmonary rehabilitation, were selected for the evaluation of pulmonary drainage. During the pre- and post-operative periods, patients were submitted to plethysmography and six-minute walk tests, as well as completing the following quality of life questionnaires: Medical Outcomes Study 36-item Short-Form Health Survey, Saint George's Respiratory Questionnaire, Eastern Cooperative Oncology Group Performance Status and Medical Research Council Scale. In all three cases, the postoperative follow-up period was at least 300 days. The tests were performed at the following time points: during the pre-operative period; between post-operative days 30 and 40; and on post-operative day 300. Data were analyzed using profile plots of the means.
  
  
  RESULTS
  When the results obtained in the pre-operative period were compared to those obtained at the two post-operative time points evaluated, improvements were observed in all parameters studied.
  
  
  CONCLUSIONS
  The results suggest that the surgical technique proposed for the treatment of patients suffering from severe diffuse emphysema successfully reduces the debilitating symptoms of these patients, improving their quality of life considerably.
authors.affiliation: Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil. rsaad@uol.com.br
authors.forename: Roberto
authors.initials: R
authors.lastname: Saad Junior
authors.forename: Vicente
authors.initials: V
authors.lastname: Dorgan Neto
authors.forename: Marcio
authors.initials: M
authors.lastname: Botter
authors.forename: Roberto
authors.initials: R
authors.lastname: Stirbulov
authors.forename: Jorge Henrique
authors.initials: JH
authors.lastname: Rivaben
authors.forename: Roberto
authors.initials: R
authors.lastname: Gonçalves
mesh_terms: D004322:Drainage / Q000379:methods*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010993:Plethysmography, Whole Body; D011184:Postoperative Period; D011300:Preoperative Care; D011656:Pulmonary Emphysema / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D012123:Pulmonary Ventilation / Q000502:physiology; D011788:Quality of Life; D014109:Total Lung Capacity / Q000502:physiology; D016138:Walking