Surgery to Reduce Lung Volume

Emphysema can cause substantial functional impairment and is one of the leading causes of death in the United States. Our ability to treat emphysema is severely limited because the principal physiologic deficiency results from the destruction of the architecture of the lung. The development of lung transplantation, first of a single lung and later of both in sequence, was the first direct approach to the treatment of advanced emphysema. However, most patients with severe disease are precluded from undergoing this surgery by advanced age and coexisting conditions. In addition, the postoperative regimen of immunosuppression causes substantial morbidity and mortality. Lung-reduction . . .