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Ann Thorac Surg 1996;61:1468-1469
© 1996 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 1464.

DR HAROLD C. URSCHEL, JR (Dallas, TX): I compliment Dr Miller and his coauthors on an excellent presentation. I agree with the lessons that he stated here. I rise to point out the value of the unilateral approach to these problems. Because of coronary artery bypass grafts, many of our patients initially required a unilateral lung approach. We hesitated to flip them over and do the other side because we would be putting forced ventilation on the previously operated lung on the downside. Therefore we did one lung at a time. The amazing observation is how much better these patients did than our bilateral cases.

Before epidural anesthesia, we did most of our lung resections through a median sternotomy. The patients did perfectly well, unless we violated the other pleura for one reason or another, and then they did not do quite as well as the ones who just had a single side operated on. We prefer staging the high-risk, elderly, or ``panic'' patients undergoing volume reduction operations, doing one side at a time. . . . [Full Text of this Article]

Related Article

Lung Volume Reduction Surgery: Lessons Learned

Joseph I. Miller, Jr, Robert B. Lee, and Kamal A. Mansour
Ann. Thorac. Surg. 1996 61: 1464-1468. [Abstract] [Full Text]