Utz J P, Hubmayr R D, Deschamps C
Division of Pulmonary and Critical Care Medicine and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905, USA.
Mayo Clin Proc. 1998 Jun;73(6):552-66. doi: 10.4065/73.6.552.
Lung volume reduction surgery (LVRS) has recently been rediscovered and offers the potential of improving the quality of life of patients with advanced emphysema. In this article, we discuss the historical and contemporary versions of LVRS. Although initial enthusiasm has been substantial, existing data seem insufficient to demonstrate the safety and efficacy of the procedure in comparison with conventional medical therapy. Fundamental questions remain regarding the long-term effects of an operation versus medical therapy, the optimal selection criteria, the best measures of efficacy, the mechanisms of improvement, the cost-effectiveness of the procedure, and the optimal surgical technique. Until such questions are answered, advising patients about the best management their emphysema will be difficult. The National Emphysema Treatment Trial will address many of these issues and should be embraced by both health-care providers and patients.
肺减容手术（LVRS）最近再度受到关注，并有望改善晚期肺气肿患者的生活质量。在本文中，我们讨论了肺减容手术的历史版本和当代版本。尽管最初人们对此热情高涨，但现有数据似乎不足以证明该手术与传统药物治疗相比的安全性和有效性。关于手术与药物治疗的长期效果、最佳选择标准、疗效的最佳衡量指标、改善机制、手术的成本效益以及最佳手术技术等基本问题仍然存在。在这些问题得到解答之前，向患者建议肺气肿的最佳治疗方案将很困难。国家肺气肿治疗试验将解决其中许多问题，医疗服务提供者和患者都应予以关注。
