The History of Surgical Procedures for Emphysema

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Presentation transcript:

The History of Surgical Procedures for Emphysema Joel D Cooper, MD The Annals of Thoracic Surgery Volume 63, Issue 2, Pages 312-319 (February 1997) DOI: 10.1016/S0003-4975(96)01227-1

Fig. 1 Part of the lung of Dr Samuel Johnson from “The Morbid Anatomy of the Human Body” by Dr Mathew Baillie, who performed Dr Johnson’s autopsy. Published in London in 1793. The Annals of Thoracic Surgery 1997 63, 312-319DOI: (10.1016/S0003-4975(96)01227-1)

Fig. 2 (A) Preoperative chest roentgenogram of a 61-year old man with severe emphysema before left lung transplantation. (B) Roentgenographic appearance after left lung transplantation. Mediastinal shift toward the transplant has decompressed the right chest with overall improvement in diaphragmatic position and chest wall configuration. The Annals of Thoracic Surgery 1997 63, 312-319DOI: (10.1016/S0003-4975(96)01227-1)

Fig. 3 Actuarial survival curve of patients receiving unilateral or sequential bilateral lung transplantation at the Washington University Lung Transplant Program (n = 259). The Annals of Thoracic Surgery 1997 63, 312-319DOI: (10.1016/S0003-4975(96)01227-1)

Fig. 4 Preoperative chest roentgenogram of a 49-year old woman with α1-antitrypsin deficiency. Note marked distension of thorax, elevation of ribs, and depressed diaphragm. The Annals of Thoracic Surgery 1997 63, 312-319DOI: (10.1016/S0003-4975(96)01227-1)

Fig. 5 The same patient as Fig. 4, several hours after sequential bilateral transplantation. Note marked improvement in diaphragmatic and chest wall position. The Annals of Thoracic Surgery 1997 63, 312-319DOI: (10.1016/S0003-4975(96)01227-1)

Fig. 6 Schematic of right lung volume reduction. A linear stapler fitted with bovine pericardial strips is successively applied to provide a continuous buttressed staple line. Approximately half of the upper lobe is removed. Resultant plication of the remaining portion of the lobe further reduces its volume. The Annals of Thoracic Surgery 1997 63, 312-319DOI: (10.1016/S0003-4975(96)01227-1)