We still don't know how long the benefits will last or how much benefit can be accrued in any one individual. But, in well-selected patients, we've seen a significant improvement in pulmonary function studies and exercise capability. At one year, patients seem to be doing very well. With emphysema, the lungs become hyperinflated or enlarged, the chest wall expands outward and the diaphragm is flattened, inhibiting the muscle action that is so essential to respiration. Surgeons remove only diseased, poorly functioning parts of the lungs to create more space for diaphragmatic excursion.
Surgeons believe the procedure works by improving the mechanisms of breathing.
The procedure was first performed in the 1950s, then abandoned. It was revived less than two years ago by St. Louis, Missouri surgeon, Joel Cooper, MD, with whom Kaiser shared a long association. Since it was first offered at Penn last year, more than 100 patients have undergone the procedure here. Lung volume reduction surgery is not a permanent substitute for lung transplantation and months of pulmonary rehabilitation are required to reap the benefits of surgery. The rehabilitation program comprises a supervised series of six-minute walks, treadmill exercises, and bicycling, said Kotloff.