Results of lung volume reduction surgery in patients with emphysema. The Washington University Emphysema Surgery Group.

Between January 1993 and April 1995, 84 patients with emphysema underwent bilateral lung volume reduction surgery at Barnes Hospital, Fifty-three patients had completed 3 months; 37 patients, 6 months; and 19 patients, 1 year of follow-up. Significant improvement was observed in spirometric parameters, oxygenation, 6-minute walking distance, dyspnea indices, and quality-of-life scores. The average increases in FEV1 were 52%, 51%, and 61%, at 3,6, and 12 months, respectively, after surgery. The most common postoperative complication, prolonged ( > 7 days) chest tube drainage, was present in 63% of the cases, and the mean duration of hospitalization in the survivors was 15 days (range 5 to 49 days). This has been reduced to 11 days (median 7.5 days) for the subsequent 40 patients. Five postoperative deaths occurred, 2 in the first, 2 in the third, and 1 in the fifth postoperative month, respectively. The overall mortality in the 84 patients was 6%, and the actuarial survival at 1 year was 93%. Volume reduction surgery is a promising therapeutic option for patients with an appropriate pattern of emphysema. Improvement has been sustained for more than 1 year, and long-term follow-up is planned to ascertain the duration of the benefits.