Contemporary surgical management of advanced end stage emphysema: an evidence based review.
Emphysema is a progressive unrelenting component of chronic obstructive pulmonary disease and a major source of mortality and morbidity globally. The prevalence of moderate to severe emphysema is approximately 5% in Malaysia and likely to increase in the future. Hence advanced emphysema will emerge as a leading cause of hospital admission and a major consumer of healthcare resources in this country in the future. Patients with advanced disease have a poor quality of life and reduced survival. Medical therapy has been largely ineffective for many patients however certain subgroups have disease amenable to surgical palliation. Effective surgical therapies include lung volume reduction surgery, lung transplantation and bullectomy. This article is a comprehensive evidence based review of the literature evaluating the rationale, efficacy, safety and limitations of surgery for advanced emphysema highlighting the importance of meticulous patient selection and local factors relevant to Malaysia.
Cardiothoracic Surgery Division, Serdang Hospital, Jalan Puchong, Kajang, Selangor 43000, Malaysia. anandsachithanandan@yahoo.com
Anand
A
Sachithanandan
Balaji
B
Badmanaban
D006801:Humans; D016040:Lung Transplantation; D018579:Patient Selection; D011013:Pneumonectomy; D011656:Pulmonary Emphysema / Q000601:surgery*