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Titolo:
Lung volume reduction surgery for chronic obstructive pulmonary disease: Where do we stand?
Autore:
McKenna, RJ; Gelb, A; Brenner, M;
Indirizzi:
Cedars Sinai Med Ctr, Dept Surg, Los Angeles, CA 90048 USA Cedars Sinai Med Ctr Los Angeles CA USA 90048 , Los Angeles, CA 90048 USA
Titolo Testata:
WORLD JOURNAL OF SURGERY
fascicolo: 2, volume: 25, anno: 2001,
pagine: 231 - 237
SICI:
0364-2313(200102)25:2<231:LVRSFC>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADVANCED EMPHYSEMA; DIFFUSE EMPHYSEMA; RESECTION; IMPROVEMENT; STERNOTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: McKenna, RJ 8635 3rd,Suite 975W, Los Angeles, CA 90048 USA 8635 3rd,Suite975W Los Angeles CA USA 90048 es, CA 90048 USA
Citazione:
R.J. McKenna et al., "Lung volume reduction surgery for chronic obstructive pulmonary disease: Where do we stand?", WORLD J SUR, 25(2), 2001, pp. 231-237

Abstract

Lung volume reduction surgery (LVRS) is a promising new treatment for selected patients with moderate to severe symptoms of emphysema. Medical management, including pulmonary rehabilitation, has been shown to reduce oxygen requirements during exercise and probably to reduce hospitalization for patients with severe emphysema, but it does not improve pulmonary function. By improving the elastic recoil of the lung, LVRS is the first treatment to demonstrate substantial improvement in pulmonary function and quality of lifefor selected patients with emphysema. The most important selection factor for LVRS is the presence of a heterogeneous pattern of emphysema. Because it is found in only 20% of patients with emphysema, only a small number of patients are candidates for the procedure. Published reports indicate that the optimal operative technique appears to be a bilateral staple operation during a single anesthetic. This procedure offers a 68% chance of oxygen independence, 85% chance of prednisone independence, and 60% to 70% improvement in pulmonary function for patients with an upper lobe distribution of emphysema. The long-term benefits of the procedure are currently unknown, so several randomized, prospective studies are now comparing LVRS with maximal medical management.

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Documento generato il 01/04/20 alle ore 22:43:49