肺気腫に対する肺容量減量手術は現代でも有用である

Volume Reduction Surgery for Advanced Emphysema is Still Worthwhile to Be Considered

肺気腫を合併した肺癌患者に対して，気腫の著しい肺を切除すると術後の呼吸機能が改善する症例があることは，以前より外科医に共有されていた経験であったようである．標準開胸で1957年にBrantiganら1）によって報告されたが，呼吸機能の改善が不安定で，術後合併症の煩雑さなどから広まらなかったようである．

Lung volume reduction surgery for emphysema became popular in 1990’s and became less common afterward. In emphysema patients, pleural pressure becomes positive and it restricts the diaphragm movement and the patency of bronchioles. The pleural pressure becomes negative after reducing the lung volume and make the diaphragm motion better and keep the bronchioles open. In order not to compromise the respiratory muscle, this operation is usually performed through median sternotomy or thoracoscopic approach. These days, the buttress materials were improved and there are still report for good results of this procedure, I believe this procedure should be one of the option for emphysema patients.