Technical issues and controversies in lung volume reduction surgery

Malcolm M. DeCamp*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

The goal of lung volume reduction surgery (LVRS) is to safely palliate dyspnea in patients suffering from emphysema. Successful LVRS demands attention to the details of patient selection, preoperative preparation, intraoperative anesthetic and surgical technique and multidisciplinary postoperative care. Expertise in and effective communication between pulmonary medicine, thoracic surgery, thoracic anesthesia, pain management services, critical care medicine, respiratory therapy and rehabilitation medicine are vital components to any LVRS program. In experienced centers, bilateral approaches yield nearly twice the physiologic benefit to unilateral LVRS without adversely affecting operative morbidity or mortality. Current practice favors stapled resection over laser ablation to achieve volume reduction. Controversy persists regarding open versus video-assisted operations. The cost-effective need for and choice of materials to buttress staple-lines to reduce the incidence of postoperative air leak have yet to be defined. Ongoing multi-center, randomized, controlled trials should define the utility and durability of LVRS for appropriately selected patients and resolve some of the residual technical controversies. Therapeutic innovations may further reduce the invasiveness of lung volume reduction strategies and allow a more tailored approach to palliate patients with moderate to severe emphysema.

Original languageEnglish (US)
Pages (from-to)391-398
Number of pages8
JournalSeminars in thoracic and cardiovascular surgery
Volume14
Issue number4
DOIs
StatePublished - Jan 1 2002

Keywords

  • Buttressing
  • Emphysema
  • Lung volume reduction surgery (LVRS)
  • Pneumoplasty
  • Surgical technique(s)
  • Video-assisted thoracic surgery (VATS)

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Technical issues and controversies in lung volume reduction surgery'. Together they form a unique fingerprint.

Cite this