Læknablaðið - 15.12.2011, Side 22

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ENGLISH SUMMARY
Lung volume reduction surgery for severe pulmonary emphysema in lceland
Gunnarsson Sl, Johannsson KB, Gudjonsdottir M, Jonsson S, Beck HJ, Magnusson B, Gudbjartsson T
Introduction: Lung volume reduction surgery (LVRS) can benefit patients with severe emphysema. The aim of this study was to evaluate the outcome
of LVRS performed in lceland.
Materials and methods: A prospective study of 16 consecutive patients who underwent bilateral LVRS through median sternotomy between January
1996 and December 2008. All patients had disabling dyspnea, lung hyperinflation, and emphysema with upper lobe predominance. Preoperatively all
patients underwent pulmonary rehabilitation. Spirometry, lung volumes, arterial blood gases and exercise capacity were measured before and after
surgery. Mean follow-up time was 8.7 years.
Results: Mean age was 59.2 ± 5.9 years. All patients had a history of heavy smoking. There was no perioperative mortality and survival was 100%,
93%, and 63% at 1, 5, and 10 years, respectively. The forced expiratory volume in 1 second (FEV,) and the forced vital capacity (FVC) improved signi-
ficantly after surgery by 35% (p<0.001) and 14% (p<0.05), respectively. The total lung capacity, residual volume and partial pressure of C02 also sho-
wed statistically significant improvements but exercise capacity, 02 consumption and diffusing capacity of the lung for CO did not change. Prolonged
air leak (a7 days) was the most common complication (n=7). Five patients required reoperation, most commonly for sternal dehiscence (n=4).
Conclusion: In this small prospective study, FEV, and FVC increased and lung volumes and PaC02 improved after LVRS. Long term survival was satis-
factory although complications such as reoperations for sternal dehiscence were common and hospital stay therefore often prolonged.
Key words: Lung volume reduction surgery (LVRS), emphysema, lung function, complications, outcome, survival.
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