Our Summary

This research looks into two types of surgery used to treat severe emphysema: lung volume reduction surgery (LVRS) and lung transplantation (LTx). Some have questioned whether having LVRS before a transplant might reduce the patient’s chance of survival after the transplant.

To investigate this, the researchers looked at medical records of patients who had a lung transplant between 1993 and 2014. They compared the outcomes for those who had previously had LVRS to those who hadn’t.

They found that having had LVRS didn’t affect the patient’s chance of surviving the transplant surgery, or their long-term survival rates. This suggests that having LVRS shouldn’t stop a patient from being considered for a lung transplant.

In fact, because there are not enough lung donors for everyone who needs a transplant, the researchers suggest that LVRS could be used to delay the need for a transplant in some carefully chosen patients.

FAQs

  1. Does having lung volume reduction surgery (LVRS) before a lung transplantation (LTx) affect the patient’s chance of surviving the transplant?
  2. Can LVRS be used to delay the need for a lung transplant?
  3. How did the researchers determine that having LVRS doesn’t affect the patient’s survival rate after a lung transplant?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow the post-operative care instructions carefully. This may include taking prescribed medications, attending follow-up appointments, practicing breathing exercises, avoiding smoking and other harmful substances, and gradually increasing physical activity as advised by the healthcare team. By following these instructions, the patient can help promote healing, reduce the risk of complications, and improve overall recovery outcomes.

Suitable For

Patients with severe emphysema who have not responded well to other treatments, such as medications or oxygen therapy, are typically recommended for lung surgery. These patients may experience symptoms such as severe shortness of breath, chronic cough, and difficulty performing daily activities.

Patients who are candidates for lung volume reduction surgery (LVRS) are usually those with severe emphysema that is localized to specific areas of the lungs. LVRS involves removing damaged lung tissue to improve lung function and reduce symptoms.

Patients who are candidates for lung transplantation (LTx) are those with end-stage lung disease who have not responded well to other treatments and have a poor prognosis. Lung transplantation is considered a last resort treatment option for patients with severe lung disease.

Overall, the decision to recommend lung surgery for a patient is based on a thorough evaluation of their medical history, symptoms, lung function tests, and overall health. The goal of lung surgery is to improve the patient’s quality of life and potentially extend their lifespan.

Timeline

  1. Diagnosis and evaluation: A patient with severe emphysema is evaluated by a healthcare provider and may undergo various tests to determine the extent of their condition and whether they are a candidate for surgery.

  2. Preoperative preparation: Before surgery, the patient will undergo a thorough preoperative evaluation to assess their overall health and readiness for surgery. They may need to make lifestyle changes, such as quitting smoking, and may undergo pulmonary rehabilitation to improve their lung function.

  3. Lung surgery: The patient undergoes either lung volume reduction surgery (LVRS) or lung transplantation (LTx) to treat their severe emphysema.

  4. Postoperative recovery: After surgery, the patient will be closely monitored in the hospital for any complications and will receive care to manage pain and promote healing.

  5. Rehabilitation: The patient may undergo pulmonary rehabilitation to regain strength and improve lung function after surgery.

  6. Long-term follow-up: The patient will continue to be monitored by their healthcare provider to ensure they are healing well and to address any long-term complications or issues that may arise.

Overall, the timeline for a patient before and after lung surgery involves thorough evaluation, surgery, recovery, rehabilitation, and long-term follow-up to ensure the best possible outcome for the patient.

What to Ask Your Doctor

  1. What are the potential benefits of lung volume reduction surgery (LVRS) for my condition?
  2. What are the potential risks and complications associated with LVRS?
  3. How will LVRS affect my overall lung function and quality of life?
  4. How will having LVRS impact my eligibility for a lung transplant in the future?
  5. What is the typical recovery process like after LVRS surgery?
  6. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  7. How experienced is the surgical team in performing LVRS procedures?
  8. What are the criteria for being considered for a lung transplant, and how does having had LVRS affect my eligibility?
  9. What are the potential long-term outcomes and complications associated with a lung transplant?
  10. How will the decision to have LVRS or a lung transplant be personalized to my specific medical history and condition?

Reference

Authors: Inci I, Iskender I, Ehrsam J, Caviezel C, Hillinger S, Opitz I, Schneiter D, Weder W. Journal: Eur J Cardiothorac Surg. 2018 Mar 1;53(3):596-602. doi: 10.1093/ejcts/ezx318. PMID: 28957998