Our Summary

The study compared two types of lung volume reduction procedures - Endobronchial Lung Volume Reduction (EBLVR) and Robot Assisted Thoracoscopic Surgery (RATS) LVRS. Some believe EBLVR should be the preferred method as it supposedly uses fewer hospital resources, balancing out the higher cost of the necessary endobronchial valves.

To test this, the researchers analyzed data from 177 procedures over a four-year period, with 83 patients undergoing RATS LVRS and 94 undergoing EBLVR. They found that EBLVR had no complications in 39% of cases, but 30% of patients experienced a spontaneous pneumothorax (a collapsed lung) and 31% needed further surgery. In comparison, 8% of the RATS LVRS patients were readmitted due to complications, but none required additional surgery.

While RATS LVRS had a longer operating time and hospital stay compared to uncomplicated EBLVR, it was similar to the operating time and hospital stay for EBLVR that required further surgery or resulted in a collapsed lung.

In conclusion, EBLVR does use fewer hospital resources than RATS LVRS if there are no complications. However, if complications do occur and additional surgeries are required, this advantage is lost. The researchers suggest that the decision to use EBLVR over RATS LVRS should not be made on the basis of a potentially smoother and faster recovery process.

FAQs

  1. What are the two types of lung volume reduction procedures compared in this study?
  2. What were the results of the study comparing EBLVR and RATS LVRS in terms of complications and resource use?
  3. Should the decision to use EBLVR over RATS LVRS be based on the potential for a smoother and faster recovery process?

Doctor’s Tip

Instead, the decision should be based on the individual patient’s specific health condition and risk factors. It is important for patients to discuss the potential risks and benefits of each procedure with their doctor to make an informed decision about which type of lung volume reduction surgery is best for them.

Suitable For

Patients who may be recommended for lung surgery include those with severe emphysema, chronic obstructive pulmonary disease (COPD), lung cancer, or other lung diseases that have not responded to other treatments. These patients may experience symptoms such as shortness of breath, chronic cough, and difficulty breathing, which can significantly impact their quality of life. Lung surgery may be recommended as a last resort to improve lung function and alleviate symptoms in these patients.

Timeline

Before lung surgery:

  • Patient undergoes preoperative testing and evaluation to assess their overall health and determine the best treatment plan
  • Patient receives information about the surgery, including potential risks and benefits
  • Surgery date is scheduled
  • Patient may need to stop taking certain medications or make lifestyle changes in preparation for surgery

After lung surgery:

  • Patient is monitored in the recovery room for a period of time before being transferred to a hospital room
  • Patient may experience pain, discomfort, and difficulty breathing in the immediate postoperative period
  • Patient is encouraged to move and perform breathing exercises to prevent complications such as pneumonia and blood clots
  • Patient may need to stay in the hospital for a period of time depending on the type of surgery and their individual recovery process
  • Patient will have follow-up appointments with their healthcare provider to monitor their progress and address any concerns or complications that may arise.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung surgery include:

  1. What are the potential risks and complications associated with the specific type of lung surgery being recommended?
  2. What is the expected recovery time and process for this type of surgery?
  3. How many of these surgeries have you performed, and what is your success rate?
  4. What are the expected outcomes and benefits of the surgery for my specific condition?
  5. Are there any alternative treatment options available, and how do they compare in terms of effectiveness and recovery?
  6. Will I need any additional follow-up procedures or treatments after the surgery?
  7. What is the long-term prognosis for my condition after undergoing this surgery?
  8. How will my lung function be impacted after the surgery, and what lifestyle changes may be necessary?
  9. What can I do to prepare for the surgery and optimize my recovery?
  10. Are there any specific risks or complications that I should be aware of based on my individual health history?

Reference

Authors: Lee M, Dhanji AR, Perikleous P, Baranowski R, Lau KKW, Waller D. Journal: Int J Chron Obstruct Pulmon Dis. 2024 May 9;19:1021-1032. doi: 10.2147/COPD.S442380. eCollection 2024. PMID: 38741941