title: [What place for lung volume reduction surgery for emphysema?]
abstract: Lung volume reduction surgery (LVRS) has been part of the management for the treatment of selected emphysematous patients for two decades. In a large randomized American trial (NETT), lung volume reduction surgery was shown to improve overall survival at 5 years as well as exercise capacity and health-related quality of life, especially in cases of upper-lobe-predominant emphysema and low exercise capacity. Inclusion criteria were pretreatment FEV1≤45 %, TLC≥100 %, RV≥150 %, room air resting PaCO2≤60mmHg and PaO2≥45mmHg. Patients with FEV1≤20 % and either a DLCO<20 % or homogeneous emphysema were at increased risk of mortality following LVRS and should not be considered for this procedure. Despite this evidence base, lung volume reduction surgery is performed infrequently, competing with lung transplantation and new endoscopic volume reduction techniques.
authors.affiliation: Service de chirurgie thoracique et transplantation pulmonaire, hôpital Foch, 92150 Suresnes, France.
authors.forename: J
authors.initials: J
authors.lastname: De Wolf
authors.affiliation: Service de chirurgie thoracique et transplantation pulmonaire, hôpital Foch, 92150 Suresnes, France. Electronic address: p.bonnette@hopital-foch.org.
authors.forename: P
authors.initials: P
authors.lastname: Bonnette
authors.affiliation: Service de chirurgie thoracique et transplantation pulmonaire, hôpital Foch, 92150 Suresnes, France.
authors.forename: É
authors.initials: É
authors.lastname: Sage
authors.affiliation: Service de pneumologie, hôpital Foch, 92150 Suresnes, France.
authors.forename: A
authors.initials: A
authors.lastname: Hamid
mesh_terms: D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008168:Lung / Q000473:pathology / Q000601:surgery*; D009929:Organ Size; D011013:Pneumonectomy / Q000266:history / Q000379:methods* / Q000706:statistics & numerical data*; D011656:Pulmonary Emphysema / Q000601:surgery*
keywords: Chirurgie de réduction de volume pulmonaire; Chirurgie thoracique; Emphysema; Emphysème; Lung volume reduction surgery; Thoracic surgery