Lung volume reduction surgery for emphysema

The unilateral and bilateral procedures were done in one stage, as one operation, except in the study by Lowdermilk et al.30 In this study, 21% of the patients in the bilateral group had two operations performed 9.5 months (mean value) apart. [...] The characteristics of these studies and of the patients enrolled in them are described in Tables 4a and 4b. [...] As variances were not reported for the length of time that the chest tube stayed in the patient, it was impossible to determine if the difference between the two groups was significant. [...] The mortality associated with the two procedures is described in Table 8. Two studies27,31 showed that the RR of in-hospital death was lower in the unilateral group than in the bilateral group [RRs (95% CI) were 0.64 (0.04, 9.52) and 0.74 (0.40, 1.35) respectively], but it was not significant, as indicated by the 95% CI. [...] They found that 79% and 88% of the patients reported better QoL in the unilateral and bilateral groups respectively (p=0.03) and 61% and 71% reported better breathing in the unilateral and bilateral groups respectively (p=0.03).