Patient selection for lung volume reduction surgery

Chronic obstructive pulmonary disease (COPD) is a category of heterogeneous diseases with a varying pathophysiologic basis , varying degrees of chronic airflow obstruction, and hyperinflation. The incidence in the United States is estimated to be at least 10 million patient-reported cases, although surveys have suggested that up to 24 million individuals might have impaired lung function . At least two million individuals are estimated to suffer from predominantly emphysema . The economic burden of these disorders is huge and increases with more severe disease . Furthermore, a marked impairment of quality of life is noted in these patients as the disease progresses . Over the past 50 years many advances have been made in the management of COPD. Despite these advances many patients continue to experience incapacitating breathlessness and exercise limitation. As a result, surgical therapy has been examined as a potential therapeutic option for patients who have COPD. Recent reviews and the groundbreaking results of the National Emphysema Treatment Trial (NETT) support the contention that lung volume reduction surgery (LVRS) has proven to be particularly promising as a therapeutic intervention for highly selected patients who have emphysema, but not all patients who undergo LVRS experience clinical or physiologic benefits . It is likely that selection of appropriate patients is crucial for identifying patients who are most likely to experience benefit from surgical volume redu...
Source: Chest Surgery Clinics of North America - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research