Reduction pneumonoplasty for emphysema. Early results.

Abstract

The authors determined the role of Nd:YAG laser reduction pneumonoplasty for selected patients with diffuse emphysema. The study is based on the concepts introduced 30 years ago by Brantigan regarding the value of lung reduction surgery in patients with emphysema. The authors used minimally invasive techniques with the hopes of providing appropriate clinical results with the least surgical morbidity. Fifty-five patients with advanced symptomatic emphysema were treated with unilateral Nd:YAG laser reduction pneumonoplasty to achieve lung volume reduction. Patients experienced significant improvement in exercise capacity and relief of breathlessness. This correlated with improvement in objective measures of pulmonary function and with reduction in lung volume by radiographic and spirometric measures. Significant associated hospital morbidity and a 5.5% mortality were associated. These encouraging results with treatment of only one lung will be built on with both sequential lung and simultaneous, bilateral lung treatment protocols.