• COPD – 4TH leading cause of death in the United States.
• More than 12 million people in the US currently have a diagnosis of COPD
• Estimated that another 12 million people have the disease but do not know it
Lung volume reduction surgery:
A surgery that removes a portion of the top part of each lung.
The surgery can be done by
1. Making one incision and dividing the breastbone
2. Making a 5-6 inch incision on each side of the chest
3. Making 3 1 inch incisions on each side of the chest and using a camera at the end of a rod to see.
What does the surgery accomplish?
For some patients, life span will be increased.
For some patients, changes may include
1. less shortness of breath with exertion or exercise
2. improved exercise capacity
3. decreased need for oxygen
What is emphysema?
A progressive disease that causes difficulty breathing by obstructing airflow.
The lungs are made of lots of clusters of air sacs that are like clusters of tiny balloons. In normal lungs, air flows in and makes the balloons bigger for a short time and then air flows out and the balloons get smaller again.
1. The walls of the air sacs may not stay open the usual amount of time
2. There may be mucus build up
3. The walls of the air sacs may be thickened and inflamed
This causes less air to be able to flow in and out of the air sacs with breathing. Most of the effect is on the ability of the air to flow out. This causes the lungs to be expanded more than usual which makes:
1. The muscles of breathing less efficient because they are already partially stretched when a person takes a breath
2. The rib cage less able to expand and contract as usual to help reinflate the lungs
3. The more functional part of the lung gets compressed by the lung that is overinflated. The more functional part of the lung cannot work as well as it could. It gets less blood flow and performs less gas exchange.
So, if the over inflated lung that does not function as well is removed, it results in
1. Decreased size of the portion of lung that does not function well
2. More expansion of the lung that is working better
3. Less overstretching of the breathing muscles and ribcage
...all of which give the lungs a chance to work better and help a person feel less short of breath.
Because the patients who have this surgery often have other medical issues in addition to their severe emphysema, only certain patients will be able to recover from the surgery without a lot of other problems and gain benefit from the surgery. Therefore, patients are carefully tested to see if the surgery may be a helpful treatment for them.