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Lung Volume Reduction Surgery who to targer

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By Jason Mann No BS pulmonary critical care fellow
Gerard J Criner, Francis Cordova, Alice L Sternberg, Fernando J Martinez
Substantial information regarding the role of lung volume reduction surgery (LVRS) in severe emphysema emanates from the National Emphysema Treatment Trial (NETT). The NETT was not a crossover trial and therefore was able to examine the effects of optimal medical management and LVRS on short- and long-term survival,as well as lung function, exercise performance, and quality of life.The NETT generated multiple insights into the preoperative, perioperative,and postoperative management of patients undergoing thoracotomy; described pain control techniques that were safe and effective; and emphasized the need to address nonpulmonary issues to optimize surgical outcomes...
October 15, 2011: American Journal of Respiratory and Critical Care Medicine
Alfred Fishman, Fernando Martinez, Keith Naunheim, Steven Piantadosi, Robert Wise, Andrew Ries, Gail Weinmann, Douglas E Wood
BACKGROUND: Lung-volume-reduction surgery has been proposed as a palliative treatment for severe emphysema. Effects on mortality, the magnitude and durability of benefits, and criteria for the selection of patients have not been established. METHODS: A total of 1218 patients with severe emphysema underwent pulmonary rehabilitation and were randomly assigned to undergo lung-volume-reduction surgery or to receive continued medical treatment. RESULTS: Overall mortality was 0...
May 22, 2003: New England Journal of Medicine
Sridhar Rathinam, Inger Oey, Mick Steiner, Tom Spyt, Mike D Morgan, David A Waller
OBJECTIVES: Lung volume reduction surgery (LVRS) for advanced emphysema is well established, with strong evidence from the National Emphysema Treatment Trial. However, there is still reluctance to offer the procedure, and many have looked for alternative, unproven treatments. The multidisciplinary approach has been well established in treatment of lung cancer and, more recently, in coronary artery surgery. We reviewed our practice to validate the role of our multidisciplinary team approach in our LVRS programme...
December 2014: European Journal of Cardio-thoracic Surgery
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