Vats lung reduction in patients with advanced emphysema

We prospectively analyzed the intermediate-term results of thoracoscopic lung reduction performed unilaterally or bilaterally in selected patients with advanced emphysema. Unilateral lung reduction was performed intentionally in patients with asymmetric emphysema (n=21). Overall, among 39 patients operated on unilaterally, 13 subsequently underwent contralateral treatment during the follow-lip. One-stage bilateral lung reduction was intentionally performed in 8 patients with symmetric emphysema. Mortality rate was 2.1% (n=1) and morbidity rate was 36% (n=17). Mean hospital stay was 10.5 days. At 6 months, significant improvement was achieved as regards FEV1, FVC, dyspnea index, and six minute walk test, indipendently by the surgical approach. In particular FEV1 improved of 40% in unilaterally treated patients, whereas in the bilateral group FEV1 improved of 57% and 42% after one-stage or two-stage reduction, respectively. Both unilateral and bilateral thoracoscopic lung reduction can produce significant improvement in dyspnea, lung function and quality of life in properly selected patients.