Lung volume reduction surgery

Since the re-introduction of lung volume reduction surgery (LVRS) almost a decade ago, significant controversy has centered on its role in the treatment of severe emphysema. Some of the initial concerns about LVRS abated as improvements in patient selection and refinement in operative techniques and postoperative care resulted in decreased morbidity and mortality. Initial studies addressed the short-term benefits of LVRS and reported improvement in functional status and quality of life in patients undergoing the operation. More recently large retrospective studies have shown substantial and sustainable long-term benefits of LVRS. Additionally, the results of the much anticipated National Emphysema Treatment Trial (NETT) have been recently been released showing an improvement in survival in a subgroup of patients with predominantly upper-lobe emphysema and low baseline exercise tolerance. Taken together, the multitude of studies in the literature show the validity of LVRS as a treatment option for a select group of emphysema patients. This review will discuss the history of LVRS, the patient selection process, the operative technique, the postoperative care of these patients, and the results.