[Surgery for emphysema: recent advances].
BACKGROUND
The treatment of chronic obstructive pulmonary disease has progressed considerably over the past 40 Years but, for most patients with advanced disease, medical management does not often produce more than limited benefits, particularly in terms of quality of life.


BACKGROUND
Over the last decade the surgical treatment of emphysema, which was previously limited to bullectomy, has seen important developments: for carefully selected patients lung Volume reduction surgery and lung transplantation now offer the possibility of real symptomatic improvement and even prolonged survival. Thanks to the thousands of patients who have received these treatments our understanding of the pathophysiological mechanisms, surgical techniques, risks and benefits, medium and long-term results, and selection criteria has improved considerably.


CONCLUSIONS
This review summarises the most important aspects of these developments and discusses the role of Volume reduction and lung transplantation in the treatment of advanced emphysema.
Estenne
M
M
Service de Pneumologie, Hôpital Erasme, Bruxelles, Belgique. mestenne@ulb.ac.be
D003362:Cost-Benefit Analysis; D006801:Humans; D007320:Inspiratory Capacity; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality / Q000523:psychology / Q000639:trends*; D018579:Patient Selection; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality / Q000523:psychology / Q000639:trends*; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014939:Work of Breathing