scholarly journals Lung Volume Reduction Surgery in Patients with Heterogenous Emphysema: Selecting Perspective

2019 ◽  
Vol 7 (24) ◽  
pp. 4389-4392
Author(s):  
Nguyen Truong Giang ◽  
Trung Nguyen Ngoc ◽  
Nguyen Van Nam ◽  
Nguyen Viet Nhung ◽  
Ta Ba Thang ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Pulmonary Function Tests ◽  
Volume Reduction ◽  
Military Hospital ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Function Tests ◽  
Significant Difference ◽  
Preoperative Factor

BACKGROUND: Lung volume reduction surgery (LVRS) was introduced to alleviate clinical conditions in selected patients with heterogenous emphysema. Clarifying the most suitable patients for LVRS remained unclear. AIM: This study was undertaken to specifically analyze the preoperative factor affecting to LVRS. METHODS: The prospective study was conducted at 103 Military Hospital between July 2014 and April 2016. Severe heterogenous emphysema patients were selected to participate in the study. The information, spirometry, and body plethysmographic pulmonary function tests in 31 patients who underwent LVRS were compared with postoperative outcomes (changing in FEV1 and CAT scale). RESULTS: Of the 31 patients, there was statistically significant difference in the outcome of functional capacity, lung function between two groups (FEV1 ≤ 50% and > 50%) (∆FEV1: 22.46 vs 18.32%; p = 0.042. ∆CAT: 6.85 vs 5.07; p = 0.048). Changes of the FEV1 and CAT scale were no statistically significant differences in three groups residual volume. Patients with total lung capacity < 140% had more improved than others (∆FEV1: 23.81 vs 15.1%; p = 0.031). CONCLUSION: Preoperative spirometry and body plethysmographic pulmonary function tests were useful measures to selected severe heterogenous emphysema patients for LVRS. Patients with FEV1 ≤ 50%, TLC in the range of 100-140% should be selected.

Lung perfusion scintigraphy prior to lung volume reduction surgery

2003 ◽  
Vol 44 (3) ◽  
pp. 246-251 ◽  
Author(s):  
K. Cederlund ◽  
S. Högberg ◽  
L. Jorfeldt ◽  
F. Larsen ◽  
M. Norman ◽  
...  
Keyword(s):  
Lung Volume ◽  
Imaging Techniques ◽  
Lung Perfusion ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Perfusion Scintigraphy ◽  
Lung Volume Reduction ◽  
Lung Perfusion Scintigraphy ◽  
Significant Difference

Purpose: The aim of this study was to evaluate whether lung perfusion scintigraphy (LPS) contributes to the preoperative classification of emphysema heterogeneity in patients undergoing LVRS (lung volume reduction surgery) compared to classification based only on computed tomography (CT). Material and Methods: Forty-five potential candidates for LVRS were examined with CT and LPS. The distribution of emphysema within the lungs was visually classified into three categories: markedly heterogeneous, intermediately heterogeneous, or homogeneous. The results of the two imaging techniques were compared to an objective, CT-based computerized classification of heterogeneity. Results: Visual evaluation of all 90 lungs resulted in 50 correct classifications based on CT, in 40 based on LPS and in 68 correct classifications based on the combination of CT and LPS. The combination was superior to CT alone ( p<0.01) in classification of emphysema heterogeneity. There was no significant difference between the evaluations based on either CT or LPS. Conclusion: The combined information from CT and LPS are superior in assessing emphysema heterogeneity prior to LVRS.

scholarly journals Identification of target zones for lung volume reduction surgery using three-dimensional computed tomography rendering

2020 ◽  
Vol 6 (3) ◽  
pp. 00305-2020
Author(s):  
Claudio Caviezel ◽  
Tamara Froehlich ◽  
Didier Schneiter ◽  
Urs Muehlematter ◽  
Thomas Frauenfelder ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Volume ◽  
New Technology ◽  
Pulmonary Function Tests ◽  
Three Dimensional ◽  
Forced Expiratory Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Target Zones ◽  
Lung Volume Reduction

BackgroundThe key issues for performing lung volume reduction surgery (LVRS) is the identification of the target zones. Recently introduced three-dimensional computed tomography rendering methods are used to identify the morphological distribution and its severity of lung emphysema by densitometry. We demonstrate a new software for emphysema imaging and show the pre- and post-operative results in patients undergoing LVRS planned based on this new technology.MethodsA real-time three-dimensional image analysis software system was used pre- and 3 months post-operatively in five patients with heterogeneous emphysema and a single patient with homogeneous morphology scheduled for LVRS. Focus was on low attenuation areas with <950 HU, distribution on both lungs and the value of the three-dimensional images for planning surgery. Functional outcome was assessed by pulmonary function tests after 3 months.ResultsFive patients underwent bilateral LVRS and one patient had unilateral LVRS. All patients showed a median increase in forced expiratory volume in 1 s of 70% (range 30–120%), compared with baseline values. Hyperinflation (expressed as residual volume/total lung capacity ratio) was reduced by 30% (range 5–32%). In the patients with heterogeneous emphysema, the pre- and post-operative computed tomography scans and the densitometries showed a decrease in low attenuation areas by 23% (right side) and by 17% (left side), respectively.ConclusionWe demonstrate three-dimensional computed tomography-rendered images for planning personalised remodelling of hyperinflated lungs using LVRS. This user-friendly software has the potential to assist surgeons and interventional pulmonologists to select patients and to visualise target areas in LVRS procedures.

Small Airway Morphometry and Improvement in Pulmonary Function after Lung Volume Reduction Surgery

2005 ◽  
Vol 171 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Victor Kim ◽  
Gerard J. Criner ◽  
Heba Y. Abdallah ◽  
John P. Gaughan ◽  
Satoshi Furukawa ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Small Airway ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction

Loss of pulmonary function gains after lung volume reduction surgery

1999 ◽  
Vol 18 (3) ◽  
pp. 266-268 ◽  
Author(s):  
Steven Kesten ◽  
Ellen Elpern ◽  
William Warren ◽  
Peter Szidon
Keyword(s):  
Pulmonary Function ◽  
Lung Volume ◽  
Volume Reduction ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction
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