Lung volume reduction surgery, or LVRS, can improve the quality of life for certain COPD and emphysema patients. Parts of the lung that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work better.
Conventional LVRS involves resection of the most severely affected areas of emphysematous, non-bullous lung (aim is for 20-30%). This is a surgical option involving a mini-thoracotomy for patients suffering end stage COPD due to underlying emphysema, and can improve lung elastic recoil as well as diaphragmatic function.
Increased mortality, contraindicating the procedure, is noted in patients that have both:
The National Emphysema Treatment Trial (Fishman et al., 2003) was a large multicentre study (N = 1218) comparing LVRS with medical treatment. Results suggested that:
I miss my sweetest friend
like a house on fire wants its ghosts back again.
We got all turned around, now let's turn ourselves in.
And so you know, you're always welcome home.
That door ain't ever gonna close,
and my heart ain't ever gonna close.
I've been wrestling horses to the ground.
I was the coldest gust of wind
and now the heart I belong in is frozen.
I've come scattered and unhinged,
oh where are my pacific oceans?
I've been wrestling horses to the ground.
I want to ride my bike out to Alaska.
I don't care what's there, I wanna see a moose.
Maybe I'll die out in Alaska.
Maybe I'll die beneathe the moon.