LUNG-VOLUME REDUCTION SURGERY FOR EMPHYSEMA

There has been dramatic resurgence of interest in surgical treatment o f emphysema, particularly ''lung volume reduction'' procedures, Recent studies have demonstrated improvements in pulmonary function, rung me chanics, exercise tolerance, and quality of life in selected patients following volume reduction procedures. However, considerable uncertain ty remains regarding overall benefit, optimal patient selection, opera tive techniques, and duration of response. This review summarizes curr ent approaches to lung volume reduction surgery, available clinical ou tcome information, selection criteria, and physiologic mechanisms of r esponse, and discusses the potential role for surgical volume reductio n in treatment of emphysema. Recent data appear to support the efficac y of bilateral staple lung volume reduction surgery in patients with s evere symptomatic heterogeneously distributed emphysema, Further studi es will be needed to determine relative value of different operative t echniques and benefit in patients with other clinical presentations.