Effect of Lung Volume Reduction Surgery on Bony Thorax Configuration in Severe COPD: Materials and Methods

Patient Selection
Our study was performed with 25 consecutive patients who underwent LVRS at Temple University Hospital. All patients enrolled in our LVRS program had severe emphysema, were on optimal medical therapy (bronchodilators, inhaled and/or oral corticosteroids, home oxygen therapy, and comprehensive outpatient pulmonary rehabilitation), and were clinically stable with no evidence of acute respiratory symptoms. They had no evidence of kyphoscoliosis or history of chest trauma, did not reveal any thoracic or parenchymal abnormalities on routine CXR other than those consistent with the diagnosis of COPD, and fulfilled the inclusion criteria shown in Table 1. All patients signed informed consent, as approved by our Institutional Review Board for Human Research.
All patients had plain CXRs, CT scans, routine pulmonary function tests, and 6-min walk distance test (6MWD) done within 3 weeks before LVRS. CXRs were available in 25 patients and CT scans in 14 patients at 3 months after LVRS. Seven of the above patients had plain CXRs done previously, within a year before their baseline presurgical evaluation. These were analyzed and compared with the preoperative and postoperative data. Also, a subgroup of patients (n = 10) had CT scans obtained 1 year after surgery, and these too were analyzed and compared with the preoperative and 3-month postoperative LVRS data. Buy Flovent Inhaler

Physiologic Measurements
Pulmonary Function Testing: Pulmonary function testing was performed with a plethysmograph (System 6200 Autobox DL Plethysmograph; SensorMedics Corp; Yorba Linda, CA) using American Thoracic Society guidelines. FVC, FEV1, and FEV1/ FVC ratio were measured. Thoracic gas volumes were measured in a body plethysmograph. All postbronchodilator pulmonary function data are reported in absolute numbers and as percent of normal predicted values. The 6MWD test (the total distance that the patient was able to walk in 6 min in a closed corridor) was also recorded.

Category: COPD

Tags: bony thorax, COPD, emphysema, lung volume reduction surgery, thoracic diameters