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Discussing surgery for COPD

Desmond | Lead Clinician

May-29-2022 | Physiology

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If you have Chronic Obstructive Pulmonary Disease COPD, you may benefit from lung surgery. Only a small number of people however have the type of COPD that will benefit from surgery. The major types of surgery for COPD are bullectomy, lung volume reduction LVRS, and lung transplantation. 

Emphysema (not chronic bronchitis) causes air sacs to become overinflated. When air sacs get very large, they are called bullae. These extra-large air sacs begin to press on the healthier lungs, preventing the healthier air sacs from working properly as they are supposed to. Bullectomy is a surgical procedure that can remove giant bullae which occupy a greater area of the chest. Very few people have these giant bullae. Most people with COPD from emphysema have many small areas of damaged air sacs in their lungs. These small damaged air sacs are often scattered throughout both lungs and therefore would not benefit from a bullectomy. 

Some patients with emphysema have greater air sac damage in the upper portions of both lungs and healthier air sacs in the bottom portions. In these patients, lung volume reduction surgery can remove the upper portion of both lungs. Like a bullectomy, LVRS sometimes removes some good air sacs as well. After taking out this mostly non-working part of the lung, you may breathe better. Because this is major surgery, you must have a strong heart and healthy remaining lungs to make the risk of having the surgery worthwhile. You must be willing to keep physically fit by stopping smoking and completing a pulmonary rehabilitation program. 

Lung transplantation replaces one or both of your lungs with a lung from an organ donor. The best COPD candidates for lung surgery have no other major health problems and have such severe lung disease that, the benefits of surgery outweigh the risks. There are many serious complications of lung transplant and therefore most COPD patients are not good candidates.

Note: This article is for informational purposes only and is not intended as medical advice, or as the substitute for the medical advice of a physician.