Lung Volume Reduction Surgery

What is lung volume reduction surgery?

Lung volume reduction surgery (LVRS) can be used to treat certain people with chronic obstructive pulmonary disease (COPD). It may be an option for patients who have a certain kind of emphysema that mainly damages the upper parts of the lungs, who are less than 75 years of age, who are not current smokers, and who cannot exercise well despite doing pulmonary rehabilitation.1,2

People with emphysema have damage to the millions of tiny air sacs in the lungs. These air sacs (alveoli) are where oxygen is absorbed from the air a person breathes. The body needs enough oxygen to function well. The damage caused by emphysema can keep the lungs from absorbing enough oxygen.

During LVRS, surgeons remove about 30% of the damaged upper part of the patient’s lungs. This can improve the way the healthier remaining portions of the lungs function, which can make breathing easier and reduce the symptoms of COPD.2,3

Which COPD patients may have the option of LVRS?

LVRS is a major surgery, and all major surgeries carry the risk of complications. For this reason, it is important to make sure that surgery is the best option for the individual with COPD – the benefits need to outweigh the risks. Whether or not LVRS is an option depends on:

  • The type of emphysema the person has
  • How severe the emphysema is
  • Whether most of the lung damage is in the upper parts of the lungs2,3

To be considered for LVRS surgery, patients usually need to meet the following conditions:

  • The patient cannot be a current smoker
  • The patient needs to complete a pulmonary rehabilitation program before the surgery
  • The patient needs to be motivated to exercise and stay active after the surgery2,3

Patients who undergo LVRS also need to have good general fitness levels and heart function, so it may not be an option if they have certain kinds of heart conditions.

What are the possible benefits of LVRS for people with COPD?

By removing the most damaged parts of the lungs, LVRS can help the healthier remaining parts of the lungs to work better and improve the patient’s breathing. The surgery can also allow the diaphragm to move back into its normal position and make the breathing process more effective. The diaphragm is a large, flat muscle that sits just under the lungs. It plays a key role in expanding the lungs during the breathing process.2,3

Other benefits of LVRS may include:

What risks are linked to LVRS?

Because it is a major surgery, patients have a risk of complications from LVRS. The most common complication is the risk of air leaks, where air leaks from the lungs into the surrounding chest cavity. To treat this complication, a chest tube is placed into the chest to drain the air. Some people may need an additional surgery to treat an air leak.2,3

Complications from LVRS are higher if the patient is more than 75 years of age or has other health conditions, including:

  • Coronary artery disease
  • Pulmonary hypertension
  • Very low lung function
  • Being very overweight or obese

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Written by: Anna Nicholson and Emily Downward | Last reviewed: April 2018.