A surgical approach to treating emphysema: lung volume reduction surgery.

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in Americans. In addition, COPD significantly affects the quality of life of afflicted patients. Historically, the treatment for emphysema has been primarily medical and includes medications, smoking cessation, and pulmonary rehabilitation. Recently a surgical procedure, lung volume reduction surgery (LVRS) has been reintroduced as a treatment for end-stage lung disease, primarily emphysema. In LVRS, wedge resections are performed to reduce the size of the lungs and improve alveolar functioning. This article describes the evaluation of patients who undergo LVRS and the associated pathophysiology in addition to the surgical procedure, inclusion and exclusion criteria, pre- and postoperative care, potential complications, and preliminary data associated with the procedure at one facility. Although LVRS is not a procedure for all patients with emphysema, it may significantly improve the quality of life of selected patients.