The most common postoperative complication has been persistent air leakage, which has been minimized by using the bovine pericardial strips and by not using suction on the chest tubes. No patient has required reoperation for air leaks and none have returned to the operating room because of bleeding. An additional patient committed suicide several weeks after successful surgery. The average hospital stay has been 10 days. After discharge, patients have continued with pulmonary rehabilitation and are followed on a regular basis, with data collected and entered into a national registry.
All patients are off oxygen.
Conclusion Lung volume reduction surgery is a viable option for carefully selected patients with end-stage emphysema. Lung volume reduction surgery has been used as a bridge to transplantation. But most patients who are evaluated for lung volume reduction surgery, however, will not become candidates because they do not meet the current selection criteria. The current status of reimbursement is such that most third-party payers have withheld payment for lung volume reduction surgery based on the notion that it is still an experimental procedure. Medicare has embarked on a long-term study to evaluate this further.