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LUNG VOLUME REDUCTION SURGERY

Chronic bronchitis and emphysema are lung diseases usually caused by cigarette smoking. The small windpipes of the lung become narrow and distorted. This makes it harder to breath in and out. The lung tissue which absorbs oxygen from the air is destroyed causing spaces to be made in the lung. This is called emphysema and cannot be repaired. Chronic bronchitis and emphysema develop slowly over many years. They cause shortness of breath and cough which may be mild or severe. At first shortness of breath occurs in exercise only, but later may occur when resting. Early death is common and may occur from lung or heart failure.

Emphysema results in the lungs and chest wall becoming larger due to air being trapped in the lung by the narrow windpipes. As a result of this the muscles that are used to breath will require more oxygen than normal. At the same time the over distension makes the muscles work less well, and together these produce the sensation of breathlessness. The focus of treatment is to improve the way the windpipes work with drugs which make the windpipes wider (bronchodilators). In some cases inhaled or oral corticosteroids (drugs similar to cortisone) are also used. In severe cases oxygen may be required. Physical exercise and other breathing exercises may help.

Lung volume reduction surgery is a new treatment which involves removal of parts of the lung which are badly affected by emphysema. By removing the areas of the lung most badly affected, the function of the rest of the lung is improved. Results in some cases have shown that lung function can improve by 30 to 90%. Breathlessness is reduced and the ability to exercise and quality of life is increased. This type of surgery has some risks. About 5% of patients will die as a result of it. It is important to ensure that patients are in good physical shape before and after surgery. A variety of surgical methods can be used and these need special anaesthetic methods. In order to improve results patients need to be very carefully selected for this procedure. We do not have long-term results yet but it seems that the improvement will last for at least two to three years, but may be much longer. Experience with this type of surgery is growing, but more research is needed to assess who will benefit from the operation, the method used, why shortness of breath gets less, the long-term results and whether it is cost effective.

Lung volume reduction surgery is a new technique which offers hope to selected severely disabled patients with emphysema.

Please Note: This information is intended by The Australian Lung Foundation to be used as a guide only and is not an authoritative statement. Please consult your family doctor or specialist respiratory physician if you have further questions relating to the information provided here.

© 1997, The Australian Lung Foundation