Long-Term Results After Lung Volume Reduction Surgery: A Single Institution's Experience

TY - JOUR

T1 - Long-Term Results After Lung Volume Reduction Surgery

T2 - A Single Institution's Experience

AU - Horwood, Chelsea R.

AU - Mansour, Daniel

AU - Abdel-Rasoul, Mahmoud

AU - Metzger, Gregory

AU - Han, Jing

AU - Aggarwal, Rishav

AU - Rittinger, Mahasti

AU - Shimizu-Saito, Sheri

AU - Diaz, Philip

AU - Moffatt-Bruce, Susan

N1 - Publisher Copyright: © 2019 The Society of Thoracic Surgeons

PY - 2019/4

Y1 - 2019/4

N2 - Background: The National Emphysema Treatment Trial (NETT) showed a clear survival and quality of life benefit for patients selected for lung volume reduction surgery (LVRS). However, long-term outcomes after LVRS are still lacking. The aim of this study was to evaluate overall mortality and functional durability in this single-institution cohort of patients undergoing LVRS. Methods: A single-institution registry identified all patients who had undergone LVRS from January 2006 through August 2017. Records were retrospectively reviewed, and data were collected to include pulmonary functions test values, he University of California, San Diego shortness of breath questionnaire and complication and mortality rate. Results: LVRS was performed in 135 patients with a 2.2% 90-day mortality rate (n = 3). Estimated 1-, 2- and 5-year survival was 0.94 (95% confidence interval [CI], 0.88 to 0.97), 0.91 (95% CI, 0.83 to 0.95), and 0.71 (95% CI, 0.57 to 0.81), respectively. Mean improvement in forced expiratory volume in 1 second% predicted from preoperative baseline at 1 and 2 years was 5.3 (95% CI, 3.1 to 7.4) and 4.3 (95% CI, 1.9 to 6.6), respectively. There was a mean improvement in maximum workload of 5.2 W (95% CI, 0.9 to 9.4) at 1 year. Also, shortness of breath questionnaire scores had a mean decrease of −17.3 points (95% CI, −21.8 to −13) at 6 months and −13.9 points (95% CI, −18.4 to −9.3) at 1 year. Conclusions: LVRS is an effective operation with overall improvement in functional status and quality of life in appropriately selected patients.

AB - Background: The National Emphysema Treatment Trial (NETT) showed a clear survival and quality of life benefit for patients selected for lung volume reduction surgery (LVRS). However, long-term outcomes after LVRS are still lacking. The aim of this study was to evaluate overall mortality and functional durability in this single-institution cohort of patients undergoing LVRS. Methods: A single-institution registry identified all patients who had undergone LVRS from January 2006 through August 2017. Records were retrospectively reviewed, and data were collected to include pulmonary functions test values, he University of California, San Diego shortness of breath questionnaire and complication and mortality rate. Results: LVRS was performed in 135 patients with a 2.2% 90-day mortality rate (n = 3). Estimated 1-, 2- and 5-year survival was 0.94 (95% confidence interval [CI], 0.88 to 0.97), 0.91 (95% CI, 0.83 to 0.95), and 0.71 (95% CI, 0.57 to 0.81), respectively. Mean improvement in forced expiratory volume in 1 second% predicted from preoperative baseline at 1 and 2 years was 5.3 (95% CI, 3.1 to 7.4) and 4.3 (95% CI, 1.9 to 6.6), respectively. There was a mean improvement in maximum workload of 5.2 W (95% CI, 0.9 to 9.4) at 1 year. Also, shortness of breath questionnaire scores had a mean decrease of −17.3 points (95% CI, −21.8 to −13) at 6 months and −13.9 points (95% CI, −18.4 to −9.3) at 1 year. Conclusions: LVRS is an effective operation with overall improvement in functional status and quality of life in appropriately selected patients.

UR - https://www.scopus.com/pages/publications/85062396748

U2 - 10.1016/j.athoracsur.2018.10.014

DO - 10.1016/j.athoracsur.2018.10.014

M3 - Article

C2 - 30458157

SN - 0003-4975

VL - 107

SP - 1068

EP - 1073

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

IS - 4

ER -