Study objective: To examine whether lung volume reduction surgery (LVRS) alters the anticipated natural rates of decline in FEV1.
Design: Retrospective analysis of spirometry results (188 studies) in patients before and after bilateral LVRS. Setting. Large, urban, academic medical center.
Patients: 25 patients with severe emphysema (mean (SD) age 60+/-8 yrs; FEV1 0.74+/-0.29 L, 29% predicted).
Interventions: Bilateral LVRS performed via median sternotomy, with areas targeted for resection based on preoperative evaluation using high-resolution computed tomography, quantitative perfusion scans, and intraoperative inspection of the lungs. Linear regression analysis was performed on each patient using all serial postbronchodilator FEV1 values from before and after LVRS.
Results: Lung function data were available between 2-1001 days prior to LVRS and 71-1169 days after LVRS. Comparison of single pre- and post-LVRS FEV1 results confirmed a significant post-operative (3 month) improvement in lung function. The calculated rate of decline in FEV1 prior to LVRS was 202+/-205 mL/yr. Following LVRS, the rate of decline in FEV1 was unchanged at 178+/-150 mL/yr (p = 0.64).
Conclusions: In patients with severe emphysema, bilateral LVRS does not appear to significantly alter the rate of FEV1 decline.