Perioperative treatment of lung volume reduction surgery for severe pulmonary emphysema

Objective:To evaluate the perioperative treatment of lung volume reduction surgery (LVRS) for severe pulmonary emphysema.Methods:From July 1996 to March 2001,40 patients with severe pulmonary emphysema underwent LVRS.The LVRS was performed unilaterally in 29 patients via posterolateral thoracotomy (including pulmonary nodule resection of wedge or lobectomy during LVRS in 3 cases ) and bilateral LVRS in 11 cases through median sternotomy or bilateral anterolateral thoracotomy. 20%30% of the volume of each lung was resected.Relevant factors in the production of complications during perioperative period were analyzed,and perioperative physical exercise indications for operation and postoperative care were evaluated.Results:The operative mortality was 2 5%.The complication incidence during postoperative period was 52 5%.Morbidity included prolonged respiratory support (7 days) in 6 patients,persistent air leakage in 12 cases ,refractory ventricular extrasystole in 1 case,phrenic nerve palsy in 1 case,stress ulcer with bleeding in 1 case .Conclusions:Perioperative comprehensive pulmonary rehabilitation program,strict adherence to indications for operation,appropriate postoperative treatment are important for the success of this prosedure.