Can Patients With Emphysema Benefit From Lung Volume Reduction Surgery?
Medical Editor: Leslie J. Schoenfield, MD, PhD
Emphysema is a crippling disease that affects almost 2 million people in the USA. Smoking is the principal cause of emphysema. Genetic (inherited through genes) forms of emphysema, however, also exist. These genetic forms are caused by certain biochemical (enzyme) deficiencies in the lungs. The main symptom in patients with emphysema is shortness of breath at rest and even more so during exercise. The traditional medical treatment of emphysema includes drugs that widen or open the air passages (bronchodilator drugs), oxygen, exercise programs (regimens), and steroids when the disease worsens (exacerbates). I should point out, however, that oxygen therapy is the only treatment that has been associated with an actual improvement (increase) in the duration of life (survival) for certain patients with emphysema.
Emphysema is generally a diffuse disease of the lungs. Diffuse means that the disease is spread throughout and involves the entire lungs. Some parts of the lungs, however, may be involved more than other parts. For example, emphysema involves predominantly the upper parts (lobes) of the lungs in smokers and the lower lobes in people with the enzyme deficiencies. Conceivably, therefore, surgical removal (resection) of the diseased parts of lung can result in expansion of the healthy areas of lung. Expansion of the remaining lung would be expected to occur to make up (compensate) for the surgical loss of lung volume or just to fill the void. This expansion of lung tissue is the main principle and the rationale behind Lung Volume Reduction Surgery.