Kaga Kichizo, Kuwahira Ichiro, Iwasaki Masayuki, Iwamoto Tokuzen, Inoue Hiroshi, Matsuse Takeshi, Fukuchi Yoshinosuke
Department of Surgery, Tokai University School of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2004 Sep;42(9):803-9.
We made a national questionnaire survey of conditions and results of lung volume reduction surgery (LVRS) performed for pulmonary emphysema in 273 hospitals. The survey covered: number of hospitals, number of patients, indications, operative procedures, improvement of FEV1% and dyspnea score, mortality, cause of death, 5-year survival rate, characteristics of patients who died, and current conditions of LVRS. The response rate was 63%. A total of 619 patients at 41 hospitals underwent LVRS. The most common types of surgical procedure were bilateral LVRS through median sternotomy and unilateral LVRS with video-assisted thoracoscopic surgery (VATS), followed by bilateral LVRS with VATS. Postoperative improvement in FEV1% averaged 39%. Dyspnea improved in 80% of patients. Mortality rate was 1.9% (8 of 432 cases). Postoperative infectious diseases, namely pneumonia and sepsis, were common causes of death. The 5-year survival was 65 +/- 8%. The causes of death over 5 years were respiratory failure in 60%, malignant neoplasms in 17%, cardiovascular accidents in 13% and others in 10%. The number of operations and hospitals decreased in 2002, compared to 2001.
我们针对273家医院为肺气肿患者实施肺减容手术（LVRS）的情况及结果开展了一项全国性问卷调查。调查涵盖：医院数量、患者数量、适应症、手术操作、第一秒用力呼气容积（FEV1）百分比改善情况及呼吸困难评分、死亡率、死亡原因、5年生存率、死亡患者的特征以及肺减容手术的现状。回复率为63%。41家医院的619例患者接受了肺减容手术。最常见的手术类型是经正中胸骨切开术进行的双侧肺减容手术以及采用电视辅助胸腔镜手术（VATS）的单侧肺减容手术，其次是采用VATS的双侧肺减容手术。术后FEV1百分比平均改善39%。80%的患者呼吸困难得到改善。死亡率为1.9%（432例中有8例）。术后感染性疾病，即肺炎和脓毒症，是常见的死亡原因。5年生存率为65±8%。5年以上的死亡原因中，呼吸衰竭占60%，恶性肿瘤占17%，心血管意外占13%，其他占10%。与2001年相比，2002年手术数量和医院数量有所减少。
