LUNG-VOLUME REDUCTION SURGERY - LESSONS LEARNED

Background. The concept of lung volume reduction for generalized emphy sema was proposed by Brantigan and associates in 1958 and reintroduced by Cooper and colleagues in 1994. The present study presents lessons learned from an 18-month experience. Methods. From August 1, 1994, to August 1, 1995, 53 patients underwent lung volume reduction at Emory U niversity for generalized emphysema. There were 17 women and 36 men ra nging in age from 55 to 75 years. The length of stay ranged from 10 to 59 days. At the time of presentation, 47 patients were receiving oxyg en and 35 were receiving steroids. Forty-six patients were operated on using a median sternotomy and 7 through a unilateral thoracotomy. All patients underwent preoperative and postoperative pulmonary rehabilit ation. Results. There was one early death and four late deaths. Lesson s learned from this group of patients are presented. Conclusions. Lung volume reduction surgery remains a sea of relatively uncharted waters , with the future direction yet to be determined.