Lung volume reduction surgery is a medical procedure done to remove damaged lung tissue in a patient suffering from emphysema. Removal of the damaged lung tissue allows the diaphragm and remaining lung tissue to function more efficiently. This surgery is not a cure for emphysema, but it can reduce symptoms and make the patient feel better.
Emphysema is a progressive lung disease that usually develops in older people who smoke cigarettes, most commonly in those who have smoked for many years. Smoke can destroy the walls of the air sacs or alveoli in the lungs. These alveoli then lose their elasticity. The alveoli can expand as the patient takes a breath, but they will not contract back to their normal size when the patient exhales. The alveoli become enlarged and gas exchange in the lungs will become impaired.
The patient suffering from emphysema may experience shortness of breath, especially after physical exertion. There may also be an increase in lung infections, along with coughing and wheezing. These patients may not be able to get enough oxygen, which may give their skin a blue tint. Patients with severe emphysema may qualify for lung volume reduction surgery.
Diagnosis of emphysema is based on patient symptoms, as well as X-rays of the lungs. The enlarged alveoli in the lungs may be visible on an X-ray. Lung function testing, which involves measuring the volume of air exhaled from the lungs, is also used as a means to diagnose emphysema. Levels of oxygen and carbon dioxide can also be measured in the blood.
Treatment of emphysema usually involves getting the patient to stop smoking. The physician may also prescribe medication to reduce inflammation in the lungs. Respiratory therapy and breathing exercises may also help reduce symptoms. If the patient has severe emphysema that cannot be controlled with medication or respiratory therapy, the physician may consider surgery. To become a candidate for lung volume reduction surgery, the patient must have stopped smoking at least four months prior to surgery.
Lung volume reduction surgery is performed while the patient is under general anesthesia. There are two methods the surgeon can use to perform this surgery. A thorascopy involves insertion of a tube with a camera into the chest wall through small incisions that are made between the ribs. The surgeon then inserts surgical instruments that are used to remove up to 35% of the damaged lung tissue.
The second method of surgery is the sternotomy in which the surgeon makes an incision through the middle of the sternum bone in the chest. The chest is then opened to expose the lungs and the damaged tissue is removed. Following surgery, patients may need to spend one to two days in the intensive care unit, followed by five to seven days in the hospital. Respiratory therapy exercises would start soon after surgery.
In order for lung volume reduction surgery to be successful, patients must be committed to a rehabilitation program. This includes a support program to make sure the patient does not smoke cigarettes. Breathing exercises and physical activity can also help slow progression of emphysema. Surgery may not be a cure but it can improve lung function and give the patient more energy.
