UNILATERAL THORACOSCOPIC REDUCTION PNEUMOPLASTY FOR ASYMMETRIC EMPHYSEMA

Objective: We prospectively analyzed the surgical and functional resul ts of unilateral thoracoscopic reduction pneumoplasty which we perform ed by choice in patients with asymmetric emphysema. Methods: Between O ctober 1995 and June 1997, 119 emphysematous patients were examined an d 34 were operated upon. Among these, 14 selected patients with asymme tric distribution of emphysema in the lungs underwent unilateral reduc tion pneumoplasty (ten right, and four left). There were 13 males and one female, with a mean age of 62 years. Eligibility criteria included bullous and non-bullous end-stage emphysema with severe Limitation to daily activity. Results: No patient required conversion to thoracotom y. Mean operative time ranged between 70 and 240 min with a mean of 10 3 min. There was no postoperative mortality but five patients develope d one or more complications: five prolonged air leaks (>7 days); two p ulmonary infections; one empyema, No patient required postoperative me chanical ventilation. Median hospital stay was 8 days. At the 3-month follow-up the mean FEV1 increased from 0.81 to 1.21(P < 0.001), Mean F VC increased from 2.61 to 2.91 (P < 0.001). The Medical Research Counc il dyspnea score decreased from a mean of 3.2 to 1.8 (P < 0.001). Conc lusions: Asymmetric distribution is a frequent finding in patients wit h severe emphysema. Unilateral thoracoscopic reduction pneumoplasty ma y represent an ideal approach in this selected group of patients. (C) 1998 Elsevier Science B.V. All rights reserved.