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1998 Fiscal Year Final Research Report Summary

Indication and Comparison of Surgical Therapy for Pulmonary Emphysema

Research Project

Project/Area Number 09671402
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Thoracic surgery
Research InstitutionFukuoka University

Principal Investigator

IWASAKI Akinori  Fukuoka Univ., Sch.of Med., Lecturer, 医学部, 講師 (50248506)

Co-Investigator(Kenkyū-buntansha) YOSHIDA Minoru  Sch.of Med., Professor, 医学部, 教授 (60078772)
SHIRAKUSA Takayuki  Sch.of Med., Professor, 医学部, 教授 (20038863)
Project Period (FY) 1997 – 1998
KeywordsPulmonary Emphysema / Surgical Therapy / Volume Reduction Sergery / Thoracoscope / Median Sternotomy
Research Abstract

Pulmonary emphysema has been considered to be a irreversible disease and thought to be no surgical therapy only except lung transplantation. Recently surgical approach for pulmonary emphysema has reports in improvement of respiratory function and symptoms at United State(1 -4). But it is not clear which is better a pproach and indication. Furthermore rarely surgical indicate to the patients with emphyseme in Japan. So we study and analyze of these points in our country. Patients were selected according to the following criteria : All canditates were evaluated pulmonogist. (Patients and methods ) Indication : Dispite maximal medical management. all patients had marked symptoms, as measured by a dyspnea index and quality-of-life assessment. Smoking cessation. Chest roeotgenograms showed hyperinflated lung with flattening of the diaphragms. Computed tomography (CT) had to be helerogeneous. Radionuclide ventilation and perfusion(V/Q) lung scans were also used to confirm the heterogeneous p … More attern of emphysema. Lung function studies : All patients underwent standerd pulmonary function tests and arterial blood gases. Body plethysmography was used to mesure thoracic gas volumes function reserve cpacity. total lung capacity (TLC). and residual volume(RV). The single breath diffusion capacity for carbon monoxide(DCLO) were also measured. Pulmonary artery caiheter(Swan-Ganz) were used for circulatory function. Change in the degree of functional impairment after surgery was determined at6- month study. Operative procedures : All patients underwent general anesthesia (isofiurane) using a left-sided double-lumen tube. Thoracoscopic procedures were performed with patients in the lateral decubitus position. The trocar and thoracoscope were placed through the 6th intercostal space in the middle axillary line. Three additional 1 to 2 cm incisions were made for the endoscopic stapler and instruments. Bilateral procedures. patients were turned to the contralateral decubitus position. The preoperative lung CT scan and ventilation/perfuion scan were used to identify areas of severely emphysematous lung targeted for resection. Median sternotomy were performed in the supine position without. thoracoscopic instruments. Stastical analysis : Data are presented as mean *standard error of the mean(SEM) unless otherwise specifield. Differences between groups are compared with two-tailed paired sutudent's t test, with p<0.05 considered significant. peason's x 2 stasties were used to analyze in each VRS technique. (Results) 1 The PreOPerative and postoperative functional data are summarized as follow. Bilateral procedures. median or thoracoscope. the improvement in FVE1.0 and RV were signiticantly greater for patients with unila teral procedure. Bilateral procedures produced double improvement in FlV1.0 than unilateral. And bilateral groups. another FRC and 'TLC had significantly decreased from the preoperative baseline measurement. 2 Blood loss at operation was great significa Less

  • Research Products

    (11 results)

All Other

All Publications (11 results)

  • [Publications] 岩崎昭憲、白日高歩: "Volume reducttion surgery-肺気腫への治療効果" 医学のあゆみ. 180. 10. 660-661 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 岩崎昭憲、白日高歩: "肺気腫に対する外科治療-VRSでは肺をどれだけ取るか-" 呼吸と循環. 45. 9. 861-864 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 岩崎昭憲、桑原之尚 他: "肺気腫に対する胸腔鏡下Volume reduction surgery" JSES. 2. 3.211-216 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 岩崎昭憲、吉永康照 他: "肺気腫の手術手技、適応 : 新たなる治療法も含めて" 日本胸部疾患学会雑誌. 34. 9-11 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 岩崎昭憲、桑原之尚 他: "肺気腫に対する外科治療(pneumectomy と thoracoscopic stapled lung reduction)の比較" 日本胸部外科学会雑誌. 453. 3. 7-8 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 白日高歩: "慢性肺気腫の外科療法とその適応" 総合臨床. 46. 11. 31-32 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Yoshida, M., Iwasaki, A., Kurokawa, Y., Kuwashita, I.: "Surgical therapy for the emphysema" Kokyu. 17. 1184-1194 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Iwasaki, A., Shirakusa, T.: "Volume reduction surgery" Igakunoayumi. 180(10). 660-661 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Iwasaki, A., Shirakusa, T.: "Surgical therapy for the emphysema-how reduction for the lung" Kokyuu Junkan. 45(9). 861-864 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Iwasaki, A., Kuwahara, M., Yoshinaga, Y.: "Thoracoscopic volume reduction surgery" Jap Soc End Surg.2(3). 211-216 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Shirakusa, T., Iwasaki, A., Yoshida, M., Toyoshima, H.: "Rehabilitation of the Patient with Respiratory Disease" McGraw-Hill Companies, Inc. 529-533 (1999)

    • Description
      「研究成果報告書概要(欧文)」より

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Published: 1999-12-08  

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