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 2024/04/20
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.