166 * an Emphysema Multidisciplinary Team Is an Integral Part of a Successful Lung Volume Reduction Surgery Programme
Year: 2013
Type: conference-abstract
Abstract: Objectives: Lung volume reduction surgery (LVRS) for advanced emphysema has been well established with strong evidence from the National Emphysema Treatment Trial. However there is still reluctance to offer the procedure and many have looked for alternative, unproven treatments. The multidisciplinary team (MDT) approach has been well established in lung cancer and now coronary artery surgery. We reviewed our practice to validate the role of our MDT approach in our LVRS programme. Methods: Our MDT comprises chest physicians, radiologists and surgeons involved in case selection meetings on a regular basis. Cases are selected on the basis of clinical presentation, imaging (Q scan and CT scan) and respiratory physiology. We analysed prospectively collated data on 614 patients referred for LVRS between July 1995 to March 2013 and the outcomes. Results: Six-hundred and fourteen patients (412 male) were referred for LVRS, of whom 272 underwent LVRS (166 male, median age 61 [37-79] years). There were 248 video-assisted thoracoscopic surgical (VATS) procedures; 13 patients underwent one-stage bilateral procedures and 33 had a staged second side procedure. The overall median hospital stay was 13 (4-197) days, during which 11 patients died. Prolonged hospital stay was associated with increasing age and with duration of air leak, which was in turn associated with diffusion capacity (DLCO) and FEV1. Conclusions: The outcomes of a successful LVRS programme are not only dependent on good surgical technique and postoperative care. Case selection and work-up by a dedicated MDT for emphysema patients is an invaluable and integral part of a LVRS programme.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2317410034