Technical Aspects of Lung Volume Reduction Surgery Including Anesthetic Management and Surgical Approaches

Thorac Surg Clin. 2021 May;31(2):129-137. doi: 10.1016/j.thorsurg.2021.02.001.

Abstract

As palliative treatment, lung volume reduction surgery can be offered to a selected subset of chronic obstructive pulmonary disease patients. Careful adherence to established inclusion and exclusion criteria is critical to achieve good outcomes. The evolution of surgical techniques toward minimally invasive approaches has improved outcomes. The fully extrathoracic access combining a subxiphoid incision with subcostal port placement allowed a further decrease in perioperative pain, which favors spontaneous respiratory drive and early postoperative mobilization. Less aggressive resections and better match for size of the hemithorax have contributed to a short-term reduction in morbidity and continued improvements in cardiopulmonary function.

Keywords: LVRS; Minimally invasive thoracic surgery; Subxiphoid.

Publication types

  • Review

MeSH terms

  • Anesthesia
  • Anesthetics / therapeutic use*
  • Chest Tubes
  • Humans
  • Hypercapnia / prevention & control
  • Minimally Invasive Surgical Procedures
  • Pain, Postoperative / prevention & control
  • Physical Therapy Modalities
  • Pneumonectomy / methods*
  • Postoperative Period
  • Pulmonary Disease, Chronic Obstructive / surgery*
  • Respiration
  • Spirometry
  • Time Factors
  • Tracheostomy
  • Treatment Outcome

Substances

  • Anesthetics