Details

Autor(en) / Beteiligte

• Tutic, Michaela
• Kestenholz, P.
• Schneiter, D.
• Opitz, I.
• Kohler, M.
• Weder, W.

Titel

P-211PERIOPERATIVE MORBIDITY AND MORTALITY AFTER THORACOSCOPIC LUNG VOLUME REDUCTION SURGERY FOR ADVANCED EMPHYSEMA

Ist Teil von

• Interactive cardiovascular and thoracic surgery, 2013-07, Vol.17 (suppl_1), p.S55-S55

Ort / Verlag

Oxford University Press

Erscheinungsjahr

2013

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Objectives Lung volume reduction surgery (LVRS) in selected patients with advanced emphysema improves symptoms, pulmonary function, exercise tolerance, quality of life and may even prolong survival in comparison to medical treatment. However, despite these advantages LVRS is not adequately applied worldwide, partially due to a misleading notion of prohibitive risks. After establishing selection criteria and optimized treatment algorithms the aim of this study was to evaluate our current mortality and morbidity. Methods Two hundred and fifty-two consecutive patients (64 years [31-84], 111 females) with advanced emphysema FEV1 26% (14-58%), RV/TLC: 0.68 (0.53-0.87); DLCO: 34% (10-71%) (median and range) were treated by video-assisted thoracoscopic LVRS (77 unilateral) and analyzed from our prospective study over the last 10 years. All types of emphysema morphology including the non-heterogeneous type were accepted. Results The 90-day mortality was 1.2% (3/252). Two patients died due to cardiac insufficiencies (elevated cardiac risk profile known preoperatively) and 1 due to respiratory failure. The median drainage time was 6 days (2-43) and hospitalization was 11 days (4-91). Hundred and fourty-three (57%) patients had no complications at all. In 88 (33%) patients pulmonary complications occurred; 60 (24%) had prolonged air leaks (>7 days), 30 (12%) treated with a reoperation, 6 (2%) with pneumonia, 10 (4%) were temporarily reintubated. Two (1%) patients with severe adhesions developed a haemothorax). Thirteen (5.2%) patients had cardiovascular morbidity requiring medical and antiarrhytmic treatment. Six (2%) had a gastrointestinal complication and 11 (4%) other complications (cerebrovascular incident, urinary tract infection). Conclusions Thoracoscopic LVRS in selected patients with severe emphysema and impaired lung function is safe in a dedicated and experienced centre when the appropriate selection criteria is respected. The 90-day mortality with 1.2% is low and the perioperative morbidity is acceptable when the possible gain in quality of life is taken into account. Disclosure All authors have declared no conflicts of interest.