title: Lung volume reduction surgery 10 years later.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether favorable short-term results in term of functional outcome and survival following lung volume reduction surgery persist for longer periods. Composite preoperative and early postoperative variables were analysed.
  
  
  METHODS
  This study was conducted on 52 emphysematous patients who underwent lung volume reduction surgery (LVRS) from 1993 to 2000, through a delayed retrospective analysis that has allowed us to evaluate a long-term follow-up (10 years or more); lung function and other variables were considered with respect to survival; 11 patients submitted to lung transplantation were also evaluated.
  
  
  RESULTS
  Upper lobe distribution of emphysema (P=0.02, HR:2.43) and systolic PAP (P=0.04, HR=2.11) were significantly correlated to survival in a multivariate analysis; these variables seem to identify a small subgroup of 14 patients with longer survival (more than 10 years). Lung transplantation performed in some worsening patients (mean FEV1%:17±4) showed a trend of better survival when we compared the observed survival (55±47 months) with expected survival (39.5±15 months) (P=ns).
  
  
  CONCLUSIONS
  We conclude that LVRS can lead to a very long survival (10 years or more) in a small subgroup of patients, with improvement of pulmonary functional data. Some preoperative data (upper lobe distribution of emphysema and pulmonary arterial pressure) appear to predict survival. Lung transplantation can be offered to these patients, showing a trend to improved life expectancy.
authors.affiliation: Pulmonary Division, Ospedale S. Giovanni Battista, Turin, Italy. baldi_sergio@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Baldi
authors.forename: A
authors.initials: A
authors.lastname: Oliaro
authors.forename: G
authors.initials: G
authors.lastname: Tabbia
authors.forename: M
authors.initials: M
authors.lastname: Bardessono
authors.forename: P
authors.initials: P
authors.lastname: Solidoro
authors.forename: M
authors.initials: M
authors.lastname: Mancuso
authors.forename: C
authors.initials: C
authors.lastname: Sità
authors.forename: E
authors.initials: E
authors.lastname: Ruffini
mesh_terms: D000368:Aged; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D011656:Pulmonary Emphysema / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D012123:Pulmonary Ventilation / Q000502:physiology; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014109:Total Lung Capacity / Q000502:physiology; D016896:Treatment Outcome