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Lung volume reduction surgery for emphysema and bullous pulmonary emphysema |
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| Authors: | Le Pimpec-Barthes F Das Neves-Pereira J-C Cazes A Arame A Grima R Hubsch J-P Zukerman C Hernigou A Badia A Bagan P Delclaux C Dusser D Riquet M |
| Affiliation: | 1. Service de chirurgie thoracique, hôpital européen Georges-Pompidou, AP–HP, université Paris V-René Descartes, 20, rue Leblanc, 75015 Paris cedex 15, France;2. Service d’anatomie pathologique, hôpital européen Georges-Pompidou, AP–HP, 20, rue Leblanc, 75015 Paris, France;3. Service d’anesthésie-réanimation, hôpital européen Georges-Pompidou, AP–HP, 20, rue Leblanc, 75015 Paris, France;4. Service de radiologie, hôpital européen Georges-Pompidou, AP–HP, 20, rue Leblanc, 75015 Paris, France;5. Laboratoire de physiologie respiratoire, hôpital européen Georges-Pompidou, AP–HP, 20, rue Leblanc, 75015 Paris, France;6. Service de pneumologie, hôpital Cochin, AP–HP, Paris, France;g Université Paris V-René Descartes, Paris, France |
| Abstract: | The improvement of respiratory symptoms for emphysematous patients by surgery is a concept that has evolved over time. Initially used for giant bullae, this surgery was then applied to patients with diffuse microbullous emphysema. The physiological and pathological concepts underlying these surgical procedures are the same in both cases: improve respiratory performance by reducing the high intrapleural pressure. The functional benefit of lung volume reduction surgery (LVRS) in the severe diffuse emphysema has been validated by the National Emphysema Treatment Trial (NETT) and the later studies which allowed to identify prognostic factors. The quality of the clinical, morphological and functional data made it possible to develop recommendations now widely used in current practice. Surgery for giant bullae occurring on little or moderately emphysematous lung is often a simpler approach but also requires specialised support to optimize its results. |
| Keywords: | Emphysème Chirurgie Chirurgie de réduction pulmonaire |
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