Emphysema

Emphysema, a form of chronic obstructive pulmonary disease (COPD), is a lung disease in which the walls that separate the lung’s tiny air sacs (alveoli) are damaged.
This damage results in the lungs losing their normal elasticity. Without the ability to expand and contract with each breath, the lungs become flaccid and loose, increasingly unable to move air in and out or properly exchange oxygen and carbon dioxide between the air and blood. As the lungs become overly inflated, even the smallest physical exertion becomes difficult.
Emphysema is a major health concern worldwide. In the United States alone, it affects nearly 2 million people, with associated costs of over $2.5 billion annually. Nationwide, there are nearly 17,000 deaths attributable to emphysema every year. In general, it is a condition of later life, with almost 95% of sufferers over the age of 45

What causes emphysema?

Smoking is responsible for 82 percent of all chronic lung diseases such as emphysema.

For more information and stories from emphysema sufferers click here

What is the surgery currently performed at the SIU School of Medicine on emphysema patients?

The surgery is called Lung Volume Reduction Surgery. Currently at the SIU School of Medicine, the benefits of this surgical procedure are being studied. The goal of this procedure is to reduce the size of the lung so that the diaphragm can relax again and be able to move up and down with breathing. This allows compressed lung tissue to re-expand so less air is trapped and high negative pressures, which cause the airways to collapse, can be reduced.
The procedure requires either an incision down the middle of the chest like that used for open heart surgery or three or four one-half inch incisions on the back side of the chest. The type of incision depends on the type of emphysema. Patients are put to sleep and the surgery takes about two hours.
A stapler is used to staple off and remove diseased air sacs. A chest tube is also inserted and remains in place for several days after the surgery is performed. This tube is the primary determinant of how long patients remain in the hospital.

How long must a patient be in the hospital?

After the surgery is complete, patients are sent to the intensive or intermediate care unit overnight and then to a regular hospital bed for about 10 to 14 days. The length of the hospital stay is determined by how well the lungs seal off tiny air leaks caused by the surgery. Air leaks are monitored by the chest tube that is left in after surgery until any air leaks sealed themselves. Once leaks have sealed, the tube is taken out and most patients go home shortly after that. While patients are recovering in the hospital, they are able and encouraged to walk and perform some rehabilitative exercises even with the chest tube inserted

What are the risks for this type of surgery?

Anyone who undergoes any type of surgery is at some risk, and patients with emphysema are at more risk due to their lung condition.
After surgery, they are at a greater risk of pneumonia than patients without emphysema. It is believed there is about a five to eight percent risk of complications.

Who qualifies for the surgery?

Anyone who undergoes any type of surgery is at some risk, and patients with emphysema are at more risk due to their lung condition.
After surgery, they are at a greater risk of pneumonia than patients without emphysema. It is believed there is about a five to eight percent risk of complications.

What is expected of patients after being discharged from the hospital?

After discharge, patients are strongly encouraged to participate in an exercise program. This assists patients in obtaining the maximum benefit from their surgery. The SIU staff also requests that patients allow their progress to be monitored while providing scientific information about the postoperative course of this surgery.

Is this procedure covered by insurance?

Most insurance companies cover the procedure; however, the SIU staff can help patients obtain pre-admission authorization from their insurance carrier prior to the surgery just to be sure. Persons with Medicare should call the Cardiothoracic Surgery office to discuss current coverage.

On-Going Research

THORACOSCOPIC TREATMENT OF EMPHYSEMA
Studies the longitudinal results with patients treated with lung volume reduction surgery (LVRS) for emphysema.

VALUE OF SIX-MINUTE WALK ANALYSIS ON LVRS OUTCOME
Using a test done preoperatively (6-minute walk test) we will attempt to audit the risk for complications.