Analysis of lung volume reduction surgery results with video-assisted thoracoscopic surgery in emphysematous lung patients

Aim
In our study, we aimed to evaluate the results of patients who underwent lung volume reduction surgery with video-assisted thoracoscopic surgery due to diffuse or upper lobe limited emphysema.

Material and methods
Patients who underwent lung volume reduction surgery (LVRS) for emphysema in our clinic between March 2015 and January 2020 were included in the study. The files of the patients were evaluated retrospectively. Age, gender, smoking history, hospitalization time, drain removal time, complications, and postoperative pulmonary function test values were evaluated in the patient records.

Results
Twenty-four of the patients were male and 2 were female. The average age was determined as 49.6. Twenty-six patients underwent 31 surgical procedures, 5 of which were bilateral. Twenty-seven of them were performed by videothoracoscopic LVRS. Preoperative mean forced expiratory volume in 1 s (FEV₁) value was 32.7%, total lung capacity 132%, residual volume 280%. The average length of hospital stay was found to be 7.75 days (4–19), and the time to remove the thorax drain was 9.5 (4–23) days. FEV₁: 1.78 (48.5%) was found in the pulmonary function tests of the patients at the 6th month postoperative controls. According to preoperative FEV₁, 48.3% improvement was detected.

Conclusions
Volume reduction surgery is a treatment method that positively affects the natural course of emphysema in addition to quitting smoking and oxygen therapy. Patients with predominantly emphysema in the upper lobes, low exercise capacity, and appropriate FEV₁ values benefited most from this treatment.