Patient-directed Volume Reduction for Emphysema: Sequential Surgical and Endobronchial Techniques
نویسندگان
چکیده
BackgroundLung volume reduction (LVR) surgery has traditionally been performed as a 1-stage bilateral procedure or staged at predetermined interval. However to maximize the overall benefit we have allowed patient determine timing of further interventions and added endobronchial LVR into protocol. We reviewed long-term outcome.MethodsThree hundred thirty-one procedures were on 254 patients (median age, 61 years [range, 23-79]) with baseline predicted lung function (mean ± SD) forced expiratory in 1 second 28% 11% residual 253% 53%. The initial was by video-assisted thoracoscopic 236 (unilateral, 227; bilateral, 9), open 5, valve insertion 13. Sixty-four received 13 third procedure. median time interval between first stage 5.8 (range, 1.9-10)ResultsIn subgroup who underwent there significant improvement from 34% up 6 years. There sustained static volumes 8 years: Predicted remained reduced 259% 189%. improvements over health status: EuroQol-5D improved 50 26 62 23 (P < .01) for 5 Short Form 36-item questionnaire 9 Overall 30-day mortality 3%. Median survival 5.6 (95% confidence interval, 4.7-6.9).ConclusionsA program unilateral resulted benefits physiology status. Lung outcome. Three 1.9-10) In 4.7-6.9). A
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ژورنال
عنوان ژورنال: The Annals of Thoracic Surgery
سال: 2021
ISSN: ['1552-6259', '0003-4975']
DOI: https://doi.org/10.1016/j.athoracsur.2020.08.015