Lung Volume Reduction Surgery and Lung Volume Reduction in Advanced Emphysema: Who and Why?

Gerard J Criner; A. James Mamary

doi:10.1055/s-0030-1254075

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2010; 31(3): 348-364
DOI: 10.1055/s-0030-1254075

Lung Volume Reduction Surgery and Lung Volume Reduction in Advanced Emphysema: Who and Why?

Gerard J. Criner¹ ^, ² , A. James Mamary¹

¹Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania
²Temple Lung Center, Temple University School of Medicine, Philadelphia, Pennsylvania

Abstract

ABSTRACT

Emphysema is a disabling and progressive disease that is hallmarked by decreased exercise tolerance and impaired quality of life. Hyperinflation is the sentinel physiological characteristic of emphysema that has been shown to be responsible for exercise intolerance, dyspnea, impaired quality of life, and mortality. Surgical interventions that reduce lung volume have been the focus of multiple proposed interventions over the past century; however, evidence documenting their effectiveness has been lacking. Recently, lung volume reduction surgery (LVRS) has undergone rigorous study in the National Emphysema Treatment Trial (NETT) that documented its short and long-term effectiveness, associated morbidity and mortality, and essential characteristics that predict success or failure. Additional recent investigation has examined the use of less invasive techniques, predominantly bronchoscopic techniques that reduce lung volume without open thoracotomy. This article summarizes the major results of the NETT and briefly reviews some preliminary results of studies examining new techniques of bronchoscopic lung volume reduction.

KEYWORDS

Emphysema - COPD - lung volume reduction surgery - lung volume reduction

Full Text

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Gerard J CrinerM.D.

Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine

745 Parkinson Pavilion, 3401 North Broad St., Philadelphia, PA 19140

Email: crinerg@tuhs.temple.edu