Clinical analysis for patients with severe chronic emphysema treated by lung volume reduction surgery

Objective To study effectiveness and safety of lung volume reduction surgery(LVRS) in treatment for severe chronic emphysema(chronic obstructive pulmonary disease).Methods Clinical data of 24 patients of severe chronic emphysema undergone with LVRS during January 2004 to June 2007 were analyzed retrospectively.LVRS was performed for the patients after respiratory tract preparation based on their pulmonary function,results of blood gas analysis,cardiac function,as well as physical activity capacity.and surgical incision Was selected based on"target"location of emphysema with chest computerized tomography and isotope lung perfusion scanning,22 cases with standard unilateral LVRS via outer post-lateral incision and two with bilateral LVRS via mid-sternal incison.A linear device for cutting and stitching was used in surgical operation to excise the lung tissues of severe emphysema with strips of bovine pericardium to prevent air leakage.Results All the patients were followed-up for 19 months in average and complications occurred in seven of them after operation,including four with leakage of the alveoli.two with cardiac arrhythmia and one with pneumonia,and no death was observed.Pulmonary function and symptoms of dyspnea improved obviously in all the patients after operation,and they all could care for themselves,in general,with scales of dyspnea increased to grade Ⅰ in one case,to grade Ⅱ in 10 cases and to grade Ⅲ in three cases.Conclusions LVRS can improve pulmonary function of selected patients with severe emphysema,to certain extent,and its safety will depend on strict selection of the patients and correct peri-operative care. Key words: Pneumonectomy; Pneumonectomy emphysema; Treatment outcome