Surgical approaches for lung volume reduction in emphysema

Hopkinson, Nicholas S.; Polkey, Michael I.; Clark, Samuel J.; Zoumot, Zaid; Bamsey, Olivia; Dusmet, Michael; Lim, Eric; Jordan, Simon

Abstract

Lung volume reduction surgery (LVRS) for chronic obstructive pulmonary disease (COPD) is recommended in both British and international guidelines because trials have shown improvement in survival in selected patients with poor baseline exercise capacity and upper lobe-predominant emphysema. Despite this, few procedures are carried out, possibly because of historical concerns about high levels of morbidity and mortality associated with the operation. The authors reviewed data on lung volume reduction procedures at their institution between January 2000 and September 2012. There were no deaths within 90 days of unilateral LVRS (n=81), bullectomy (n=20) or intracavity drainage procedures (n=14). These data suggest that concerns about surgical mortality should not discourage LVRS in selected patients with COPD, provided that it is undertaken within a multidisciplinary team environment involving appropriate patient selection. © Royal College of Physicians 2014. All rights reserved.

• Journal Article Type: Article
• Publication Date: Mar 1, 2014
• Deposit Date: Aug 8, 2014
• Publicly Available Date: Nov 15, 2016
• Journal: Clinical Medicine, Journal of the Royal College of Physicians of London
• Print ISSN: 1470-2118
• Electronic ISSN: 1473-4893
• Publisher: Royal College of Physicians
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 2
• Pages: 122-127
• DOI: https://doi.org/10.7861/clinmedicine.14-2-122
• Keywords: lung volume reduction surgery, emphysema, under-treatment, risk, mortality
• Public URL: https://uwe-repository.worktribe.com/output/819344
• Publisher URL: http://dx.doi.org/10.7861/clinmedicine.14-2-122
• Contract Date: Nov 15, 2016