A surgical approach for patients with endstage emphysema

For patients with emphysema who experience deteriorating lung function and concomitant comorbidity, there has been little to offer apart from best supportive care and more recently pulmonary rehabilitation. The early promise of lung transplantation for these patients has failed to materialize--a shortage of donors has meant that younger patients are more likely to receive donor lungs. A renewed interest in lung volume reduction surgery (LVRS) appears to offer hope for selected patients. This article looks at the history of LVRS and illustrates its benefits with a case study. However, if LVRS is a clinically significant approach to the treatment of emphysemic patients, then it requires careful clinical trials so that its benefits and costs can be fully evaluated.