Surgical management of severe emphysema in Australia: Lung transplant and lung volume reduction surgery

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Abstract

In Australia, the therapeutic options available for the management of severe emphysema have expanded with the introduction of lung volume reduction surgery (LVRS) in 1995. In addition to its use as a definitive therapy for highly selected patients with severe emphysema. LVRS has been suggested as an alternative or bridge to lung transplantation (LTx). PURPOSE: To describe the extent and outcomes of LVRS & LTx for emphysema in Australia between January 1995 and December 1999. METHODS: Demographic and survival data for patients having had LVRS or LTX for non alpha 1 antitrypsin deficiency emphysema from 1995 - 1999 was obtained from the Australian and New Zealand LVRS database and Australian LTx database. RESULTS: LTx LVRS P Total number of patients 126 344 Mean number (range) 26 (20-30) 77 (38-103) operations/year Mean age at surgery 54 +/- 6 yrs 62.5 +/- 7 yrs <0.05 Gender 44% male 56 % male O.I7NS 30 day survival 94% 95% NS 90 day survival 91% 91% NS At 6.0 LTX per million population (pmp) and 18.0 LVRS pmp this number of procedures represents amongst the highest national level of surgical servicing of emphysema in the world. The majority of patients undergoing LVRS are aged 65 yrs and potentially may otherwise be under consideration for LTx. Only 1 patient who has had LVRS has gone on to LTx at this time. CONCLUSIONS In Australia. LVRS has added significantly to the surgical management of emphysema and although performed on older patients has similar early mortality outcomes. Further study is needed to investigate long term outcomes such as quality of life and mortality- and to compare these procedures with medical management.

Original languageEnglish
Pages (from-to)A33-A33
Number of pages1
JournalRespirology
Volume6
Issue numberSUPPL. 1
Publication statusPublished - 2001
Externally publishedYes

Keywords

  • Lung transplant
  • Lung volume reduction surgery

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