Am. J. Respir. Crit. Care Med., Volume 163, Number 7, June 2001, 1562-1566

Lung Function 5 yr after Lung Volume Reduction Surgery for Emphysema

ARTHUR F. GELB, ROBERT J. McKENNA Jr., MATTHEW BRENNER, JOEL D. EPSTEIN, and NOE ZAMEL

Pulmonary Division, Department of Medicine, Lakewood Regional Medical Center, University of California, Los Angeles, California; School of Medicine, University of California, Irvine, California; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Thoracic Surgery, Chapman Medical Center, Orange, California; and Cedars-Sinai Medical Center and University of California, Los Angeles, California

Current datum more than 2 yr after lung volume reduction surgery (LVRS) for emphysema is limited. This prospective study evaluates pre-LVRS baseline and 5-yr results in 26 symptomatic patients (mean age 67 ± 6 yr) (mean ± SD) who underwent bilateral, targeted upper lobe stapled LVRS using video-assisted thoracoscopy. Baseline forced expiratory volume in 1 s (FEV₁) was 0.7 ± 0.2 L (mean ± SD), 29 ± 10% predicted. Following LVRS, with none lost to follow-up, mortality due to respiratory failure at 0.5, 1, 2, 3, 4, and 5 yr was 4%, 4%, 19%, 31%, 46%, and 58%, respectively. Increase above baseline for FEV₁ > 200 ml and/or FVC > 400 ml at 1, 2, 3, 4, and 5 yr post-LVRS was noted in 73%, 46%, 35%, 27%, and 8% of all patients; decrease in dyspnea grade  1 in 88%, 69%, 46%, 27%, and 15%; and elimination of initial oxygen dependence in 18 patients in 78%, 50%, 33%, 22%, and 0%, respectively. Expiratory airflow improved due to the increase in both lung elastic recoil and small airway intraluminal caliber. Five patients decreased FEV₁ 141 ± 60 ml/yr and FVC 102 ± 189 ml/yr over 3.8 ± 1.2 yr post-LVRS, similar to their pre-LVRS rate of decline. In the 11 patients who survived 5 yr, at 0.5-1.0 yr post-LVRS peak increase in FEV₁ was 438 ± 366 ml, with a decline of 149 ± 157 ml the following year and 78 ± 59 ml/yr over 4.0-4.5 yr. Bilateral LVRS provided palliative clinical and physiological improvement in 9 of 26 patients at 3 yr, 7 at 4 yr, and 2 at 5 yr.

This article has been cited by other articles:

				G. J. Criner, P. Belt, A. L. Sternberg, Z. Mosenifar, B. J. Make, J. P. Utz, F. Sciurba, and for the National Emphysema Treatment Trial Researc Effects of Lung Volume Reduction Surgery on Gas Exchange and Breathing Pattern During Maximum Exercise Chest, May 1, 2009; 135(5): 1268 - 1279. [Abstract] [Full Text] [PDF]

				W. Weder, M. Tutic, D. Lardinois, W. Jungraithmayr, S. Hillinger, E. W. Russi, and K. E. Bloch Persistent Benefit From Lung Volume Reduction Surgery in Patients With Homogeneous Emphysema Ann. Thorac. Surg., January 1, 2009; 87(1): 229 - 237. [Abstract] [Full Text] [PDF]

				H. O. Coxson, P. V. Nasute Fauerbach, C. Storness-Bliss, N. L. Muller, S. Cogswell, D. H. Dillard, C. L. Finger, and S. C. Springmeyer Computed tomography assessment of lung volume changes after bronchial valve treatment Eur. Respir. J., December 1, 2008; 32(6): 1443 - 1450. [Abstract] [Full Text] [PDF]

				D. Mineo, V. Ambrogi, L. Frasca, M. E. Cufari, E. Pompeo, and T. C. Mineo Effects of Lung Volume Reduction Surgery for Emphysema on Glycolipidic Hormones Chest, July 1, 2008; 134(1): 30 - 37. [Abstract] [Full Text] [PDF]

				E. P. Ingenito, D. E. Wood, and J. P. Utz Bronchoscopic Lung Volume Reduction in Severe Emphysema Proceedings of the ATS, May 1, 2008; 5(4): 454 - 460. [Abstract] [Full Text] [PDF]

				F. Tacconi, E. Pompeo, D. Forcella, M. Marino, D. Varvaras, and T. C. Mineo Lung Volume Reduction Reoperations Ann. Thorac. Surg., April 1, 2008; 85(4): 1171 - 1177. [Abstract] [Full Text] [PDF]

				E. Pompeo and T. C. Mineo Two-Year Improvement in Multidimensional Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index After Nonresectional Lung Volume Reduction Surgery in Awake Patients Ann. Thorac. Surg., December 1, 2007; 84(6): 1862 - 1869. [Abstract] [Full Text] [PDF]

				J. A. Falk, U. J. Martin, S. Scharf, and G. J. Criner Lung Elastic Recoil Does Not Correlate With Pulmonary Hemodynamics in Severe Emphysema Chest, November 1, 2007; 132(5): 1476 - 1484. [Abstract] [Full Text] [PDF]

				S. Imfeld, K. E. Bloch, W. Weder, and E. W. Russi The BODE Index After Lung Volume Reduction Surgery Correlates With Survival. Chest, April 1, 2006; 129(4): 873 - 878. [Abstract] [Full Text] [PDF]

				R. B. Gorman, D. K. McKenzie, J. E. Butler, J. F. Tolman, and S. C. Gandevia Diaphragm Length and Neural Drive after Lung Volume Reduction Surgery Am. J. Respir. Crit. Care Med., November 15, 2005; 172(10): 1259 - 1266. [Abstract] [Full Text] [PDF]

				A. Palla, M. Desideri, G. Rossi, G. Bardi, D. Mazzantini, A. Mussi, and C. Giuntini Elective Surgery for Giant Bullous Emphysema: A 5-Year Clinical and Functional Follow-up Chest, October 1, 2005; 128(4): 2043 - 2050. [Abstract] [Full Text] [PDF]

				T. Troosters, R. Casaburi, R. Gosselink, and M. Decramer Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 19 - 38. [Full Text] [PDF]

				R. D. Yusen and B. Littenberg Integrating Survival and Quality of Life Data in Clinical Trials of Lung Disease: The Case of Lung Volume Reduction Surgery Chest, April 1, 2005; 127(4): 1094 - 1096. [Full Text] [PDF]

				K. Imai, B. A. Mercer, L. L. Schulman, J. R. Sonett, and J. M. D'Armiento Correlation of lung surface area to apoptosis and proliferation in human emphysema Eur. Respir. J., February 1, 2005; 25(2): 250 - 258. [Abstract] [Full Text] [PDF]

				T. C. Mineo, E. Pompeo, D. Mineo, P. Rogliani, C. Leonardis, and I. Nofroni Results of unilateral lung volume reduction surgery in patients with distinct heterogeneity of emphysema between lungs J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 73 - 79. [Abstract] [Full Text] [PDF]

				M. Tutic, K. E. Bloch, D. Lardinois, T. Brack, E. W. Russi, and W. Weder Long-term results after lung volume reduction surgery in patients with {alpha}1-antitrypsin deficiency J. Thorac. Cardiovasc. Surg., September 1, 2004; 128(3): 408 - 413. [Abstract] [Full Text] [PDF]

				F. Laghi, A. Jubran, A. Topeli, P. J. Fahey, E. R. Garrity Jr, D. J. de Pinto, and M. J. Tobin Effect of Lung Volume Reduction Surgery on Diaphragmatic Neuromechanical Coupling At 2 Years Chest, June 1, 2004; 125(6): 2188 - 2195. [Abstract] [Full Text] [PDF]

				T.E. Dolmage, T.K. Waddell, F. Maltais, G.H. Guyatt, T.R.J. Todd, S. Keshavjee, S. van Rooy, B. Krip, P. LeBlanc, and R.S. Goldstein The influence of lung volume reduction surgery on exercise in patients with COPD Eur. Respir. J., February 1, 2004; 23(2): 269 - 274. [Abstract] [Full Text] [PDF]

				T.C. Mineo, V. Ambrogi, E. Pompeo, S. Elia, D. Mineo, P. Bollero, and I. Nofroni Impact of lung volume reduction surgery versus rehabilitation on quality of life Eur. Respir. J., February 1, 2004; 23(2): 275 - 280. [Abstract] [Full Text] [PDF]

				R. A. Maxfield New and Emerging Minimally Invasive Techniques for Lung Volume Reduction Chest, February 1, 2004; 125(2): 777 - 783. [Abstract] [Full Text] [PDF]

				M. Decramer Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation Eur. Respir. J., November 16, 2003; 22(47_suppl): 47s - 56s. [Abstract] [Full Text] [PDF]

				E.W. Russi, K.E. Bloch, and W. Weder Lung volume reduction surgery: what can we learn from the National Emphysema Treatment Trial? Eur. Respir. J., October 1, 2003; 22(4): 571 - 573. [Full Text] [PDF]

				I. F. Oey, M. D.L. Morgan, S. J. Singh, T. J. Spyt, and D. A. Waller The long-term health status improvements seen after lung volume reduction surgery Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 614 - 619. [Abstract] [Full Text] [PDF]

				B. Suki, K. R. Lutchen, and E. P. Ingenito On the Progressive Nature of Emphysema: Roles of Proteases, Inflammation, and Mechanical Forces Am. J. Respir. Crit. Care Med., September 1, 2003; 168(5): 516 - 521. [Full Text] [PDF]

				S.Y. Soon, G. Saidi, M.L.H. Ong, A. Syed, M. Codispoti, and W.S. Walker Sequential VATS lung volume reduction surgery: prolongation of benefits derived after the initial operation Eur. J. Cardiothorac. Surg., July 1, 2003; 24(1): 149 - 153. [Abstract] [Full Text] [PDF]

				F. Laghi and M. J. Tobin Disorders of the Respiratory Muscles Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 10 - 48. [Abstract] [Full Text] [PDF]

				S. Appleton, R. Adams, S. Porter, M. Peacock, and R. Ruffin Sustained Improvements in Dyspnea and Pulmonary Function 3 to 5 Years After Lung Volume Reduction Surgery Chest, June 1, 2003; 123(6): 1838 - 1846. [Abstract] [Full Text] [PDF]

				H O Coxson, K P Whittall, Y Nakano, R M Rogers, F C Sciurba, R J Keenan, and J C Hogg Selection of patients for lung volume reduction surgery using a power law analysis of the computed tomographic scan Thorax, June 1, 2003; 58(6): 510 - 514. [Abstract] [Full Text] [PDF]

				R S Goldstein, T R J Todd, G Guyatt, S Keshavjee, T E Dolmage, S van Rooy, B Krip, F Maltais, P LeBlanc, S Pakhale, et al. Influence of lung volume reduction surgery (LVRS) on health related quality of life in patients with chronic obstructive pulmonary disease Thorax, May 1, 2003; 58(5): 405 - 410. [Abstract] [Full Text] [PDF]

				A. F. Gelb and R. J. McKenna Jr Lung Volume Reduction Surgery Update Chest, April 1, 2003; 123(4): 975 - 977. [Full Text] [PDF]

				E. Pompeo and T. C. Mineo Long-term outcome of staged versus one-stage bilateral thoracoscopic reduction pneumoplasty Eur. J. Cardiothorac. Surg., April 1, 2002; 21(4): 627 - 633. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2001 Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 642 - 662. [Full Text] [PDF]