AN EMPHYSEMA PATIENT WITH SEVERE HYPERCAPNIA TREATED BY UNILATERAL THORACOSCOPIC SURGERY -A CASE REPORT-

Abstract

A 77-year-old man with emphysema who had suffered from dyspnea on exertion (DOE) since 20 years before was admitted to the hospital because of the DOE gradually advanced despite of oxygen therapy during the last four years. The pulmonary function tests suggested that he had both obstructive and restrictive respiratory dysfunction and his arterial blood gas data showed that he was severely hypercapnic with PaCO₂ of 62.8 mmHg on room air. Both a chest CT and a pulmonary ventilation-perfusion scintigram suggested that he had clearly left-side dominant lesions and thus, a unilateral thoracoscopic volume reduction surgery which consisted of stapling and laser ablation was performed on his left lung. After the operation, both the symptoms and pulmonary function were remarkably ameliorated and hypercapnia was resolved with PaCO₂ of 40.9 mmHg on room air.
Our experience suggested that the unilateral thoracoscopic volume reduction surgery could be a reliable therapeutic option for some severe emphysema patients with unilateral-dominant lesions.