LUNG-VOLUME REDUCTION SURGERY AS AN EMERGENCY AND LIFESAVING PROCEDURE

Lung volume reduction surgery (LVRS) is emerging as a promising and un ique therapeutic option for rigorously selected patients with severe d ebilitating emphysema, A 51 yr old man with generalized emphysema deve loped bilateral pneumothoraces during his first holiday abroad, Due to respiratory insufficiency, intubation and mechanical ventilation were necessary, In total, six chest tubes were inserted but massive air le ak persisted and his respiratory condition deteriorated due to broncho pneumonia and sepsis, The patient was transferred to Belgium, As a las t resort, bilateral LVRS was performed through a median sternotomy, Th e most diseased areas of the upper lobes containing the air leak were resected bilaterally and a pleurectomy was associated, Three months af ter operation, there was a remarkable improvement in spirometric value s with an increase in forced expiratory volume in one second of almost 100%. The results were sustained after a follow-up of 18 months, In t his dramatic case, lung volume reduction surgery proved to be effectiv e, and was even a life saving procedure.