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Thorac Cardiovasc Surg 2025; 73(07): 571-576
DOI: 10.1055/a-2572-6755
Original Thoracic

Uniportal Video-Assisted Anatomical Lung Volume Reduction Surgery in Severe Emphysema

Authors

  • Hayan Merhej   *

    1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

  • Akylbek Saipbaev   *

    1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

  • Tomoyuki Nakagiri

    1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

  • Alaa Selman

    1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

  • Heiko Golpon

    2   Department of Pneumology and Respiratory Medicine, Hannover Medical School, Hannover, Germany

  • Tobias Goecke

    1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany

  • Patrick Zardo

    1   Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
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Abstract

Introduction

Lung volume reduction surgery (LVRS) is an important treatment option for patients with advanced emphysema and is typically performed in a non-anatomical fashion. This study reports the outcome of anatomical LVRS by means of uniportal video-assisted thoracoscopic surgery (VATS).

Methods

We retrospectively evaluated patients who underwent anatomical LVRS between June 2017 and September 2023 at our institution. Patient characteristics, including demographic data, lung function, as well as morbidity and mortality, were extracted from hospital records.

Results

A total of 44 patients (17 males, 38.6%) underwent anatomical LVRS at our institution during the observation period. The preoperative forced expiratory volume per second (FEV1) and FEV1% were 35.4 ± 20.0% and 45.7 ± 18.2%, respectively. Lobectomy was performed in 37 patients (84.1%), while segmentectomy was performed in 10 patients (22.7%, duplicated). Postoperative FEV1 and FEV1% significantly improved compared to preoperative values at the initial follow-up (11.8 ± 6.9 months after the operation): 38.3 ± 19.5%, p < 0.002 and 49.4 ± 18.4%, p < 0.01, respectively. Unfortunately, two patients (4.5%) died within 30 days postoperation. A further follow-up lung function test was performed in 25 patients (56.8%) at 33.1 ± 13.8 months after the operation, showing that FEV1 and FEV1% remained similar to the preoperative values (33.9 ± 20.7%, p = 0.10 and 45.3 ± 18.1%, p = 0.06, respectively).

Conclusion

Anatomical lung resection via uniportal VATS is an effective procedure for LVRS in patients with severe emphysema and is associated with acceptable morbidity and mortality.

Keywords

emphysema - bullae - thoracoscopy - VATS - pulmonary function

Data Availability Statement

Data available on request. The data underlying this article will be shared upon reasonable request to the corresponding author.


* These authors contributed equally to this paper.




Publication History

Received: 14 January 2025

Accepted: 01 April 2025

Accepted Manuscript online:
03 April 2025

Article published online:
30 April 2025

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