What is lung volume reduction surgery?

Lung volume reduction surgery (LVRS) is a surgical procedure to remove diseased, emphysematous lung tissue. This procedure reduces the size of an over-inflated lung and allows the expansion (growth) of the remaining, often more functional lung.

Lung volume reduction surgery is used for some patients with severe emphysema, a common type of chronic obstructive pulmonary disease (COPD), disabling dyspnea (shortness of breath, difficulty breathing), and evidence of severe air trapping (air is “trapped” in the lung and cannot get out because of the emphysema or other lung disease).

Emphysema is an ongoing and progressive disease caused largely by cigarette smoking. The disease damages the lungs and makes breathing difficult.

Who is a candidate for lung volume reduction surgery?

Lung volume reduction surgery has been shown to help improve breathing ability, lung capacity, and overall quality of life in selected patients. The effectiveness of this surgery depends on the location or extent of the diseased tissue, as well as the patient's exercise tolerance and ability to tolerate surgery.

Lung volume reduction surgery may be an appropriate treatment for select patients who meet established criteria. The results of the National Emphysema Treatment Trial (NETT) study, first published in 2003, identified four sub-groups of patients who had different risks and benefits from LVRS:

  • Group 1: Mostly upper lobe emphysema and low exercise capacity. These patients are more likely to live longer and are more likely to function better after LVRS than after medical treatment. This patient group may receive the most benefit from LVRS, as compared with the other patient groups.
  • Group 2: Mostly upper lobe emphysema and high exercise capacity. These patients are more likely to function better after LVRS than after medical treatment.
  • Group 3: Diffuse emphysema and low exercise capacity. These patients have similar survival rates and function after LVRS as after medical treatment.
  • Group 4: Diffuse emphysema and high exercise capacity. These patients have worse survival rates after LVRS than after medical treatment, and do not appear to benefit from surgery.

Patients who fall into Group 1 are the best candidates for LVRS. Your thoracic surgeon and pulmonologist (doctor who specializes in treatment of the lung and respiratory tract) will discuss your treatment options to determine the best treatment for you.

Last reviewed by a Cleveland Clinic medical professional on 07/17/2019.

References

  • Fishman A, et al. National Emphysema Treatment Trial Research Group. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med. 2003 May 22;348(21):2059-73.
  • American Lung Association. Lung Health & Diseases—Surgery. Accessed 7/15/2018.

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