| Revista: | Jornal brasileiro de pneumologia |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000297474 |
| ISSN: | 1806-3713 |
| Autors: | Figueroa, Paula Antonia Ugalde1 Martinez-Silveira, Martha Silvia Ponte, Eduardo Camelier, Aquiles Pereira-Silva, Jorge L |
| Institucions: | 1Universidade Federal da Bahia, Salvador, Bahia. Brasil |
| Any: | 2005 |
| Període: | May-Jun |
| Volum: | 31 |
| Número: | 3 |
| Paginació: | 197-204 |
| País: | Brasil |
| Idioma: | Portugués |
| Tipo de documento: | Artículo |
| Enfoque: | Caso clínico, analítico |
| Resumen en inglés | BACKGROUND: Lung volume reduction surgery is an alternative treatment for advanced pulmonary emphysema. Radiological evaluation of the type and distribution of emphysema, together with the results of pulmonary function testing, seem to be the main criteria used in deciding whether or not the procedure is indicated. OBJECTIVE: To determine the extent of scientific evidence available regarding the radiological profile of the ideal candidate for lung volume reduction surgery. METHOD: A systematic review of the literature from January 1994 to January 2004 using the following databases: MEDLINE, EMbase, LILACS, The Cochrane Library and EBM Reviews. RESULTS: Of 208 articles identified, 16 met the study criteria. Two were randomized (one multicentric, named the 'National Emphysema Treatment Trial' and including 1218 patients, and the other including only 30 patients). The other 14 articles were observational studies. The National Emphysema Treatment Trial identified a subgroup of patients with favorable prognoses when submitted to lung volume reduction surgery. This group consisted of patients with advanced heterogeneous pulmonary emphysema with upper lobe predominance, diffuse pulmonary distention and low exercise capacity. The pattern of the results obtained in the remainder of the studies was consistent with the individual analyses, despite their heterogeneity. In the observational studies, surgical benefit, mortality rates and quality of life were assessed. CONCLUSION: The radiological pattern, characterized by the type, heterogeneity, distribution and diffuse distention, together with the degree of emphysema severity, represents the main predictor of a positive surgical outcome. Due to the paucity of studies in the literature, this is a grade B recommendation |
| Resumen en portugués | CONCLUSÃO: O perfil radiológico caracterizado pelo tipo de enfisema, sua heterogeneidade, distribuição e presença de hiperdistensão difusa, ao lado do nível de gravidade, representa o principal fator preditor de bom resultado cirúrgico. Esta recomendação tem o nível de evidência B, pela escassez de trabalhos na literatura |
| Disciplines | Medicina, Bibliotecología y ciencia de la información |
| Paraules clau: | Cirugía, Diagnóstico, Neumología, Enfisema, Pulmones, Radiología, Tomografía computarizada |
| Keyword: | Medicine, Library and information science, Diagnosis, Pneumology, Surgery, Emphysema, Lungs, Radiology, Computerized tomography |
| Text complet: | Texto completo (Ver HTML) |
