RT Book, Section A1 van Berkel, Victor A1 Meyers, Bryan F. A2 Sugarbaker, David J. A2 Bueno, Raphael A2 Burt, Bryan M. A2 Groth, Shawn S. A2 Loor, Gabriel A2 Wolf, Andrea S. A2 Williams, Marcia A2 Adams, Ann SR Print(0) ID 1170412721 T1 Lung Volume Reduction Surgery T2 Sugarbaker’s Adult Chest Surgery, 3e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781260026931 LK accesssurgery.mhmedical.com/content.aspx?aid=1170412721 RD 2024/10/14 AB Lung volume reduction surgery (LVRS) is one of the most interesting and controversial areas in thoracic surgery. The purpose of the operation is to palliate dyspnea and improve functional status and quality of life for highly selected patients with emphysema. Chronic obstructive pulmonary disease (COPD) affects approximately 16 million Americans and is the fourth leading cause of death in the United States.1 Worldwide there are estimated to be 1 billion smokers, and owing to a global increase in the number of smokers each year, COPD is projected to be the third leading cause of death by the year 2020.2 When pulmonary function tests demonstrate a forced expiratory volume in 1 second (FEV1) of less than 30% of predicted values, a patient’s 3-year mortality risk has been estimated at 40–50%. Although medical therapy remains the mainstay of treatment for these patients,3 no medical therapy is able to improve pulmonary function or reverse the progressive nature of the disease. Three situations have emerged in which surgery is useful to palliate emphysema: lung transplantation, bullectomy, and LVRS. This chapter addresses the LVRS strategy.