Lung volume reduction for XXXX and the Canadian Lung Volume Reduction Surgery (CLVR) Project.

@entity1 @entity353 @entity55 @entity2415 @entity260 @entity1576 @entity291
OBJECTIVE: To review the literature on the surgical treatment of @entity2415 and to present preliminary results from a pilot study of lung volume reduction (LVR) surgery. DESIGN: Case series of consecutive @entity1 referred for LVR surgery. Outcomes were quality of life, pulmonary function and exercise capacity. SETTING: Two university-affiliated hospitals in Ontario. POPULATION STUDIED: @entity1 between the ages of 40 and 75 years with @entity2415 who had severe airflow limitation, hyperinflation of the lungs and impaired quality of life. INTERVENTION: @entity353 with multiple wedge resections of the lung using a linear stapling device with @entity291 pericardial buttressing were completed via a median sternotomy. MAIN RESULTS: Of 50 @entity1 referred, 24 underwent LVR surgery. Mean age of the cohort was 63 years. Operative 30-day or in hospital mortality was 8%. Two other @entity1 (8%) died from @entity1576 after LVR within the first year. @entity260 included prolonged air leaks (six of 24), tracheobronchitis (five of 24), mechanical ventilation (four of 24) and @entity55 (three of 24). Mean length of stay was 18 days (median 12 days). At one year, there was a sustained decrease in total lung capacity from 133% to 123% predicted. There were improvements in forced expiratory volume in 1 s, from 22% of predicted preoperatively to 32% postoperatively, and in 6 min walk performance, from 345 to 381 m. Improvements were also noted in the quality of life assessments. CONCLUSIONS: Preliminary results suggest that LVR surgery is feasible and may improve the @entity1 's quality of life, pulmonary function and exercise capacity. A randomized clinical trial comparing LVR plus the best medical management with the best medical management alone is currently underway to determine the effectiveness of LVR.
