University Hospital Gasthuisberg 49

Birżebbuġa, Malta

University Hospital Gasthuisberg 49

Birżebbuġa, Malta
SEARCH FILTERS
Time filter
Source Type

PubMed | University Hospital Gasthuisberg 49
Type: Journal Article | Journal: Acta clinica Belgica | Year: 2016

Emphysema is a disabling disease, for which there is no curative therapy available today. Lung transplantation offers a valuable option for a very selected number of patients, however, due to the enormous organ shortage, only few patients can be offered such a therapy. Recently there has been important resurgence of interest in lung volume reduction surgery and as a consequence, we have embarked in such a program since may 1997. We have now performed unilateral lung volume reduction surgery in 29 emphysema patients (25 on the right and 4 on the left side). Twenty-four patients were already discharged home. There has been no perioperative mortality. The mean hospital stay was 19.8 11.4 days (range, 8-47 d). Twenty patients of whom we already have follow-up data during 6 months (m) form the further basis of this report. Six weeks after the procedure the FEV1 increased from 0.82 0.28 L (28 8%) to 1.05 0.39 L, a mean increase of 28%. There was a further increase of the FEV1 to a maximum of 1.06 0.42 L at 6 m, a mean maximum increase of 29% (p=0.0046, ANOVA). Sim-ilarly, the FVC increased from 2.801.10Lto3.15 1.00 L, a mean increase of 12.5%. A further increase was also obtained at 6 m and was 19.6% (3.35 1.05 L, p=0.014, ANOVA). The maximum decrease in RV was obtained at 3 m (from 5.91 1.37 L to 4.37 0.85 L (p=0.0001, ANOVA), a mean decrease of 26%. The maximum TLC decrease was demonstrated at 3 m (from 8.71 1.71 L to 7.60 1.56 L (p=0.002, ANOVA), a mean decrease of 12.8%. Afterwards there was again a gradual raise of the TLC. The six minute walking distance increased from 231 31 m to 272 34 m (p=NS) after pulmonary rehabilitation and to 416 i 77 in at 3 m and 415 18 m at 6 m (p=0.0002, ANOVA) after the operation. The quality of life (measured with a standardized questionnaire, the Nottingham Health Profile ) improved significantly in several domains (e.g. mobility, pain, energy, emotions and social) at 3 m postoperatively. There was one late death (at 6 m) due to an unknown cause. The actuarial survival rate was therefore 100% at 3 m and 95% at 12 m. In conclusion, unilateral thoracoscopic lung volume reduction surgery is a new and safe treatment modality for patients suffering from severe end-stage emphysema. The objective and subjective improvement is marked and the mortality is very low. Rigid selection criteria are, however, necessary to be able to guarantee an optimal result.

Loading University Hospital Gasthuisberg 49 collaborators
Loading University Hospital Gasthuisberg 49 collaborators