Our Summary

This research paper discusses lung volume reduction surgery (LVRS), a treatment for certain patients with emphysema, a lung disease that makes it hard to breathe. This surgery has been shown to increase the chances of surviving for five years following diagnosis, as well as improving patients’ ability to exercise and their overall quality of life. However, it mainly benefits those with a specific type of emphysema that mainly affects the upper part of the lungs and who have a low exercise capacity. Certain criteria are used to decide who should have this surgery. It’s not recommended for those with the most severe symptoms or a particular form of emphysema as it can increase the risk of death. Despite the benefits of this surgery, it’s not performed very often, as it competes with lung transplants and other newer, less invasive treatments.

FAQs

  1. What is lung volume reduction surgery (LVRS) and who benefits from it?
  2. Why is LVRS not recommended for those with the most severe symptoms or a particular form of emphysema?
  3. Why isn’t LVRS performed as often as other treatments like lung transplants and less invasive treatments?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions carefully, such as stopping smoking, maintaining a healthy diet, and staying physically active. It’s important to discuss any concerns or questions with your healthcare team and to follow all post-operative instructions for a successful recovery. Additionally, attending follow-up appointments and participating in pulmonary rehabilitation programs can help optimize the benefits of the surgery and improve long-term outcomes.

Suitable For

Patients who are typically recommended for lung surgery, specifically LVRS, are those with severe emphysema that primarily affects the upper part of the lungs and who have a low exercise capacity. These patients may have symptoms such as severe shortness of breath, chronic cough, wheezing, and frequent respiratory infections. They may also have difficulty performing daily activities and experience a decreased quality of life.

It is important for patients to meet certain criteria before being considered for LVRS, including having a confirmed diagnosis of emphysema, being a non-smoker or having quit smoking, having tried other forms of treatment such as medication and pulmonary rehabilitation without significant improvement, and having a low exercise capacity as measured by pulmonary function tests.

On the other hand, patients with the most severe symptoms, those with emphysema that primarily affects the lower part of the lungs, or those with certain other medical conditions may not be recommended for LVRS as it may increase the risk of complications or death.

Overall, the decision to recommend lung surgery for a patient with emphysema is made on a case-by-case basis by a multidisciplinary team of healthcare providers, including pulmonologists, thoracic surgeons, and respiratory therapists. They will consider the patient’s overall health, lung function, and potential benefits and risks of the surgery before making a recommendation.

Timeline

Before Lung Surgery:

  1. Patient is diagnosed with emphysema and undergoes various tests to determine if they are a suitable candidate for LVRS.
  2. Patient undergoes consultations with their healthcare team to discuss the risks and benefits of the surgery.
  3. Pre-operative evaluations and preparations are done to ensure the patient is physically ready for the surgery.
  4. Patient receives instructions on how to prepare for the surgery, including medications to stop taking and fasting before the procedure.

After Lung Surgery:

  1. Patient is closely monitored in the intensive care unit immediately after the surgery to ensure there are no complications.
  2. Patient may experience pain, discomfort, and difficulty breathing in the days following the surgery.
  3. Physical therapy and breathing exercises are started to help the patient regain lung function and mobility.
  4. Patient is discharged from the hospital once they are stable and able to care for themselves at home.
  5. Follow-up appointments are scheduled to monitor the patient’s progress and address any concerns or complications that may arise.
  6. Patient undergoes rehabilitation and pulmonary rehabilitation programs to help improve their lung function and overall quality of life.

What to Ask Your Doctor

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

  1. Am I a suitable candidate for lung volume reduction surgery (LVRS)?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery period and what can I expect during the recovery process?
  4. What are the expected outcomes of the surgery in terms of improving my breathing and quality of life?
  5. Are there any alternative treatments or procedures that I should consider before opting for surgery?
  6. How experienced is the surgical team in performing LVRS procedures?
  7. Will I need any additional treatments or therapies following the surgery?
  8. How often will I need follow-up appointments and monitoring after the surgery?
  9. What lifestyle changes or precautions should I take before and after the surgery to optimize my recovery?
  10. What is the long-term outlook for patients who undergo LVRS surgery?

Reference

Authors: De Wolf J, Bonnette P, Sage É, Hamid A. Journal: Rev Mal Respir. 2017 Feb;34(2):147-154. doi: 10.1016/j.rmr.2016.05.004. Epub 2016 Jul 18. PMID: 27444695