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Traitement chirurgical de l'emphysème sévère: transplantation pulmonaire ou réduction de volume?

Schweizer, A
Published in Schweizerische medizinische Wochenschrift. 1998, vol. 128, no. 11, p. 409-15
Abstract In recent years, lung transplantation (LT) and volume reduction surgery (LVRS) have been proposed for selected patients with end-stage pulmonary emphysema. Retrospectively, we analyzed the perioperative time course of 30 patients with emphysema who underwent either LVRS (n = 17) or LT (n = 13). In the LVRS group, patients were significantly older, presented less severe functional disability and all but one could be extubated at the end of surgery. In contrast, patients undergoing LT required postoperative mechanical ventilation (19 +/- 11 hrs) and had a prolonged hospital stay (37 [25-60] days vs 19 [11-42] days in LVRS patients) due to reperfusion lung edema, infection, hemorrhage and acute rejection. Six months postoperatively, forced expiratory volume in 1 second was improved and was significantly larger after LT compared with LVRS (+200% vs +63%). Our preliminary results suggest that, although LT produces greater functional improvement, LVRS is associated with lower surgical risk and is an alternative therapy in selected patients with severe emphysema.
Keywords AgedFemaleHumansLength of StayLung Transplantation/physiologyLung Volume MeasurementsMaleMiddle AgedPneumonectomyPostoperative Complications/etiology/physiopathologyPulmonary Emphysema/physiopathology/surgeryRespiratory Insufficiency/etiology/physiopathologyRetrospective StudiesTreatment Outcome
PMID: 9561587
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Research groups Dysfonctions cardio-pulmonaires et cérébrales (278)
Pneumologie Clinique (576)
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LICKER, Marc et al. Traitement chirurgical de l'emphysème sévère: transplantation pulmonaire ou réduction de volume?. In: Schweizerische medizinische Wochenschrift, 1998, vol. 128, n° 11, p. 409-15. https://archive-ouverte.unige.ch/unige:74712

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Deposited on : 2015-08-17

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