Lung Volume Reduction Surgery for Emphysema (Lung Biology in Health and Disease) [Hardcover]

Henry E. Fessler (Editor), John J. Reilly Jr. (Editor), David Sugarbaker (Editor)

Book Description

ISBN-10: 0824708970 | ISBN-13: 978-0824708979 | Publication Date: November 14, 2003 | Edition: 1

Considering the epidemiology of COPD, this title collects all available knowledge on the subject, featuring data on the national emphysema treatment trial. It explores the epidemiology of emphysema, the management of complications and surgical controversies in lung volume reduction surgery for emphysema (LVRS).

Editorial Reviews

From The New England Journal of Medicine

The most troublesome and compelling symptom of advanced chronic obstructive pulmonary disease (COPD) with emphysema is dyspnea. Dyspnea profoundly limits the quality of life for a growing number of people worldwide who are in the advanced stages of COPD. (Figure) In 1826, Laennec, in his careful autopsies, recognized that the lungs of patients who had died from emphysema were too large -- they were entrapped in the thorax. He realized that emphysema reduced elastic recoil and impaired the function of small airways in the areas that supply ventilation to destroyed tissue. In the 1950s, Dr. Otto Brantigan, of the University of Maryland, introduced an operation that today is known as lung-volume-reduction surgery. Although he offered anecdotal and limited physiological evidence of improvement in selected patients, perioperative mortality was prohibitive, and he abandoned the operation. Brantigan attended the Eighth Aspen Emphysema Conference (the annual meeting is now known as the Aspen Lung Conference) in 1965. There he reviewed his experience in an eloquent and compelling way but did not recommend further use of the procedure. In the early 1990s, Dr. Joel Cooper, of the Washington University School of Medicine and Barnes-Jewish Hospital, resurrected the procedure, adding new approaches with the aim of forming a bridge to lung transplantation. The enthusiastic initial reports of Cooper in 1995 stimulated many thoracic surgeons to offer this procedure to their patients. But because the scientific rationale remained controversial, and because no well-designed studies had compared surgery with medical therapy, including the use of pulmonary rehabilitation and oxygen, Medicare coverage was soon denied until further studies could be conducted. These studies have now been completed. In Lung Volume Reduction Surgery for Emphysema, 30 contributors provide 20 well-written chapters that review the scientific rationale for lung-volume-reduction surgery and the initial results of the National Emphysema Treatment Trial (NETT). This is a remarkable achievement. A historical review of the study design, which required extensive statistical assumptions and adjustments during the enrollment period, and the major outcomes of the NETT are detailed in this book. The study determined that a subgroup of patients with localized apical emphysema and poor exercise tolerance after exercise training are the most likely to benefit from lung-volume-reduction surgery. The NETT was an unprecedented collaboration between the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) and the National Heart, Lung, and Blood Institute, along with the Agency for Healthcare Policy and Research (now the Agency for Healthcare Research and Quality). Together these agencies provided the massive financial support that was required for the successful completion of the study. What a Herculean effort! The mechanisms of improvement after lung-volume-reduction surgery involve the restoration of elastic recoil and diaphragmatic function. The procedure can reduce the excessive respiratory drive needed for a given effort in selected patients. The result is reduced dyspnea, improved tolerance for walking, and a better quality of life. A reduction in the use of oxygen and, in some patients, in the need for corticosteroids have been secondary outcomes. This book is a gem. It will be of great interest to all students of COPD, including clinicians, physiologists, surgeons, and radiologists. In my opinion, Lung Volume Reduction Surgery for Emphysema deserves special notice in a field that only today is receiving appropriate emphasis. COPD is the fourth most common cause of death in the United States and the only cause among the top five that is increasing in incidence. Lung-volume-reduction surgery is a breakthrough for patients who meet the established criteria, which are well outlined in this book. Although it may seem grossly overpriced, the book is worth the investment as a key historical document and reference source. Thomas L. Petty, M.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Book Description

This medical reference explains the physiology of emphysema and the role of surgical therapy in the management of this common and fatal disease. The prevalence and death rates of emphysema are increasing, but the surgical procedure examined in this text can offer emphysema patients improved lung function. --This text refers to an out of print or unavailable edition of this title.

Product Details

• Hardcover: 536 pages
• Publisher: Informa Healthcare; 1 edition (November 14, 2003)
• Language: English
• ISBN-10: 0824708970
• ISBN-13: 978-0824708979
• Product Dimensions: 9.1 x 6.3 x 1.2 inches
• Shipping Weight: 1.8 pounds (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #1,907,367 in Books (See Top 100 in Books)

Customer Reviews

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5.0 out of 5 stars [...] Book Review, May 21, 2010

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E. Russo - See all my reviews
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This review is from: Lung Volume Reduction Surgery for Emphysema (Lung Biology in Health and Disease) (Hardcover)

Medical Science Books Medical Book Review:

In the past decade no topic in pulmonary medicine and thoracic surgery has generated as much excitement and controversy as lung volume reduction surgery for emphysema. This latest installment in the continuing Lung Biology in Health and Disease series from Marcel Dekker, Lung Volume Reduction Surgery for Emphysema, represents an ambitious effort to review both science and opinion on this important topic. To this end the editors have assembled a panel of nationally-recognized experts to report on the current status of this rapidly evolving area of inquiry.

The title of this volume is too modest; the book is more than a treatise on LVRS alone. The first few chapters include excellent overviews on the epidemiology, pathology, physiology and medical therapy of emphysema. The ensuing essays on LVRS cover a wide range of key topics, including both scientific and practical considerations. Especially helpful to those planning such procedures or developing such programs are the chapters on evaluation, anesthesia and outcomes. The last essay, aptly-titled "Not the Final Chapter: The National Emphysema Treatment Trial," provides a fascinating insight into the historical, political and scientific contexts of this landmark study. The NETT is well-summarized in both the text and tables. Evaluation and management algorithms in both this chapter and Chapter 7 are particularly useful.

The book is well-presented. The Table of Contents is detailed, and the Indices are organized by both Author and Subject. These features further enhance its value as a reference tool. Despite the multiplicity of authors, redundancy is minimal. Regrettably, although it is mentioned in the Preface, the checkered history of surgical interventions for emphysema is largely ignored. Such a review of our surgical heritage could have provided a fascinating perspective from which to assess and contrast the current rigorous analysis that this book represents.

Lung Volume Reduction Surgery for Emphysema is an essential reference for those with an interest in emphysema and its surgical palliation. The editors and authors have made a major contribution to our understanding, study and treatment of this chronic and disabling condition.