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

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

Open Access Maced J Med Sci. 2019 Dec 20;7(24):4389-4392. doi: 10.3889/oamjms.2019.841. eCollection 2019 Dec 30.

Authors

Nguyen Truong Giang¹, Trung Nguyen Ngoc¹, Nguyen Van Nam¹, Nguyen Viet Nhung², Ta Ba Thang³, Dong Khac Hung³, Nguyen Duy Bac⁴, Chu Dinh Toi⁵, Pham Ngoc Hung^{4

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Affiliations

¹ Department of Cardiothoracic Surgery, Vietnam Military Medical University, Hanoi, Vietnam.
² Vietnam National Lung Hospital, Hanoi, Vietnam.
³ Department of Pneumology, Vietnam Military Medical University, Hanoi, Vietnam.
⁴ Department of Training, Vietnam Military Medical University, Hanoi, Vietnam.
⁵ Department of Human and Animal Physiology, Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam.
⁶ Department of Epidemiology, Vietnam Military Medical University, Hanoi, Vietnam.

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 ≤ 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.

Keywords: Heterogenous emphysema; Lung volume reduction surgery (LVRS); Selecting patient.