Wexner Medical Center, The Ohio State University, Columbus, Ohio.
Wexner Medical Center, The Ohio State University, Columbus, Ohio.
Ann Thorac Surg. 2019 Apr;107(4):1068-1073. doi: 10.1016/j.athoracsur.2018.10.014. Epub 2018 Nov 17.
The National Emphysema Treatment Trial (NETT) showed a clear survival and quality of life benefit for patients selected for lung volume reduction surgery (LVRS). However, long-term outcomes after LVRS are still lacking. The aim of this study was to evaluate overall mortality and functional durability in this single-institution cohort of patients undergoing LVRS.
A single-institution registry identified all patients who had undergone LVRS from January 2006 through August 2017. Records were retrospectively reviewed, and data were collected to include pulmonary functions test values, he University of California, San Diego shortness of breath questionnaire and complication and mortality rate.
LVRS was performed in 135 patients with a 2.2% 90-day mortality rate (n = 3). Estimated 1-, 2- and 5-year survival was 0.94 (95% confidence interval [CI], 0.88 to 0.97), 0.91 (95% CI, 0.83 to 0.95), and 0.71 (95% CI, 0.57 to 0.81), respectively. Mean improvement in forced expiratory volume in 1 second% predicted from preoperative baseline at 1 and 2 years was 5.3 (95% CI, 3.1 to 7.4) and 4.3 (95% CI, 1.9 to 6.6), respectively. There was a mean improvement in maximum workload of 5.2 W (95% CI, 0.9 to 9.4) at 1 year. Also, shortness of breath questionnaire scores had a mean decrease of -17.3 points (95% CI, -21.8 to -13) at 6 months and -13.9 points (95% CI, -18.4 to -9.3) at 1 year.
LVRS is an effective operation with overall improvement in functional status and quality of life in appropriately selected patients.
国家肺气肿治疗试验（NETT）表明，对于选择接受肺减容手术（LVRS）的患者，生存和生活质量明显受益。然而，LVRS 后的长期结果仍缺乏研究。本研究旨在评估该单机构队列患者接受 LVRS 后的总体死亡率和功能耐久性。
一个单机构登记处确定了 2006 年 1 月至 2017 年 8 月期间接受 LVRS 的所有患者。回顾性审查病历，并收集包括肺功能测试值、加利福尼亚大学圣地亚哥短气问卷和并发症及死亡率的数据。
对 135 例患者进行了 LVRS，术后 90 天死亡率为 2.2%（n=3）。估计 1、2 和 5 年生存率分别为 0.94（95%可信区间，0.88 至 0.97）、0.91（95%可信区间，0.83 至 0.95）和 0.71（95%可信区间，0.57 至 0.81）。术后 1 年和 2 年的用力呼气量 1 秒%预计值与术前基线相比，平均改善分别为 5.3%（95%可信区间，3.1%至 7.4%）和 4.3%（95%可信区间，1.9%至 6.6%）。术后 1 年最大工作负荷平均增加 5.2W（95%可信区间，0.9 至 9.4）。短气问卷评分在术后 6 个月平均下降-17.3 分（95%可信区间，-21.8 至-13），术后 1 年平均下降-13.9 分（95%可信区间，-18.4 至-9.3）。
LVRS 是一种有效的手术，可改善功能状态和生活质量，尤其适用于选择合适的患者。
