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Ann Thorac Surg 1999;67:815-817
© 1999 The Society of Thoracic Surgeons

Original Articles

Application of the fold plication method for unilateral lung volume reduction in pulmonary emphysema

Masayuki Iwasaki, MDa, Noboru Nishiumi, MDa, Kichizo Kaga, MDa, Masahiro Kanazawa, MDb, Ichiro Kuwahira, MDc, Hiroshi Inoue, MDa

a Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
b Department of Anesthesiology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
c Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan

Accepted for publication August 17, 1998.

Address reprint requests to Dr Iwasaki, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193 Japan

Background. Unilateral lung volume reduction procedures are used to treat pulmonary emphysema. The most significant technical problem with this operation is an air leak from the pulmonary stump. Bovine pericardium has been used to prevent air leaks but is associated with interstitial pneumonia and a high cost.

Methods. The fold plication method was devised to prevent postoperative air leaks to avoid interstitial pneumonia, and to decrease cost. This technique was applied in 20 consecutive patients with emphysema who underwent a unilateral lung volume reduction operation via a thoracoscopic two windows approach.

Results. The operative time was approximately 1 hour. There was minimal postoperative bleeding, no persistent air leaks, and no evidence of pneumonia. Pulmonary function improved in all patients.

Conclusions. The unilateral fold plication method is an economical and safe alternative to bovine pericardial patching after lung volume reduction operation to prevent stump air leaks.




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