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

Nguyen Truong  Giang; Trung Nguyen Ngoc; Nguyen Van  Nam; Nguyen Viet  Nhung; Ta Ba  Thang; Dong Khac  Hung; Nguyen Duy  Bac; Chu Dinh  Toi; Pham Ngoc  Hung

doi:10.3889/oamjms.2019.841

Authors

Nguyen Truong Giang Department of Cardiothoracic Surgery, Vietnam Military Medical University, Hanoi, Vietnam
Trung Nguyen Ngoc Department of Cardiothoracic Surgery, Vietnam Military Medical University, Hanoi, Vietnam
Nguyen Van Nam Department of Cardiothoracic Surgery, Vietnam Military Medical University, Hanoi, Vietnam
Nguyen Viet Nhung Vietnam National Lung Hospital, Hanoi, Vietnam
Ta Ba Thang Department of Pneumology, Vietnam Military Medical University, Hanoi, Vietnam
Dong Khac Hung Department of Pneumology, Vietnam Military Medical University, Hanoi, Vietnam
Nguyen Duy Bac Department of Training, Vietnam Military Medical University, Hanoi, Vietnam
Chu Dinh Toi Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam
Pham Ngoc Hung Department of Training, Vietnam Military Medical University, Hanoi, Vietnam; Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam

DOI:

https://doi.org/10.3889/oamjms.2019.841

Keywords:

Lung volume reduction surgery (LVRS), Heterogenous emphysema, Selecting patient

Abstract

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 â‰¤ 50% and > 50%) (âˆ†FEV1: 22.46 vs 18.32%; p = 0.042. âˆ†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 (âˆ†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 â‰¤ 50%, TLC in the range of 100-140% should be selected.