Surgical treatment of end stage emphysema

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Abstract

Emphysematous changes are common in the general population. A significant number of these patients requires surgical interventions. Lung volume reduction surgery (LVRS) rapidly gained popularity without a sufficient evidence of beneficial outcome; the presumed mechanism of improvement in lung function is secondary to re-expansion of more normal, underlying compressed lung. The NETT study proposed to evaluate effectiveness of medical treatment vs LVRS in patients with severe bilateral emphysema. Complete results of the NETT study are unknown yet, but there are evidences of beneficial effects of LVRS, at least in a short term. The anesthetic management of these patients includes the continuation of the bronchodilator therapy till surgery, the use of steroids and antisialologue. Pain relief must be optimal and mobilization must be early. One lung ventilation is an absolute necessity, achieved with double lumen tube insertion.

Original languageEnglish
Pages (from-to)307-312
Number of pages6
JournalMinerva Anestesiologica
Volume70
Issue number5
StatePublished - May 2004

Keywords

  • Emphysema, diagnosis
  • Emphysema, surgery
  • Lung volume reduction surgery

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