Rev Assoc Med Bras
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This study intends to review the literature on the efficacy, safety and feasibility of lung volume reduction surgery (LVRS) in patients with advanced emphysema. Studies on LVRS from January 1995 to December 2009 were included by using Pubmed (MEDLINE) and Cochrane Library literature in English. Search words such as lung volume reduction surgery or lung reduction surgery, pneumoplasty or reduction pneumoplasty, COPD or chronic obstructive pulmonary disease and surgery, were used. ⋯ Bullous emphysema was excluded from this review. Surgical approach included median sternotomy, unilateral or bilateral thoracotomy, and videothoracoscopy with stapled or laser ablation. Results of prospective randomized trials between medical management and LVRS are essential before final assessment can be established.
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To assess the relationship of clinical data and the results of preoperative pulmonary functional evaluation with postoperative pulmonary complications. ⋯ The most important factors associated with postoperative pulmonary complications were surgical site, time of anesthesia, and ASA classification.
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The aim of the study was to evaluate criteria used in clinical practice, for screening of patients for ICU admission. ⋯ Age, score system and organ dysfunctions were greater in priority groups 3 and 4 and these were related with refusal from the ICU. Patients refused admission to the ICU showed higher mortality rates and these remained higher among priority groups 3 and 4 even when patients were admitted to the ICU.