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Chapter 13 - Surgical treatment options for emphysema

from Section 2 - Anesthesia for operative procedures

Published online by Cambridge University Press:  10 December 2009

By
Christopher Wigfield  and
Cait P. Searl
Edited by
Cait P. Searl  and
Sameena T. Ahmed
Cait P. Searl
Affiliation:
Freeman Hospital, Newcastle
Sameena T. Ahmed
Affiliation:
Freeman Hospital, Newcastle
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Summary

The primary cause of emphysema is cigarette smoking. Candidates for surgery for emphysema require a complete history and examination. Three surgical treatment strategies exist for selected subgroups of emphysema patients: bullectomy, lung volume reduction surgery (LVRS), and lung transplantation (LTx). Surgical stapling devices or lasers are used to resect and seal the least functional lung segments. Stapling methods and buttressing techniques have evolved to reduce the risk of air leaks. Formal LVRS comprises a range of pulmonary resection procedures designed to achieve improved gas exchange via volumetric reduction of emphysematous lung. Lung transplantation is now an established therapeutic option for end-stage emphysema. Patients are assessed according to consensus criteria provided by the International Society for Heart and Lung Transplantation (ISHLT). The primary limitation for LTx is the shortage of suitable allograft donors, and the mortality of advanced emphysema patients on the waiting list is high.

Keywords

arterial blood gas analysiscomputed tomographygas transfer capacitylung functionspirometryMRI scan
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Chapter
Information
Core Topics in Thoracic Anesthesia , pp. 86 - 90
Publisher: Cambridge University Press
Print publication year: 2009

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