© 2003 BMJ Publishing Group & British Thoracic Society
EDITORIAL
Lung volume reduction surgery
Closing the NETT on lung volume reduction surgery
The National Emphysema Treatment Trial (NETT) of lung volume reduction surgery in patients with COPD has shown that surgery can and should be evaluated on a par with other forms of treatment.
Keywords: lung volume reduction surgery; chronic obstructive pulmonary disease
| The first 150 words of the full text of this article appear below. |
Most textbooks and many physicians now use the term "chronic obstructive pulmonary disease" (COPD) to define airflow obstruction that results from a variable combination of small airways disease and loss of elastic recoil due to emphysema. A detailed knowledge of the underlying pathology does not normally influence the treatment prescribed, with one important exception.1 Patients who have large space occupying bullae visible on their plain chest radiograph can experience significant improvements in lung function and exercise capacity if these lesions are resected, a treatment that is now well established.2 Initial attempts to extend this approach to include the resection of gross emphysematous areas of lungs were scorned by physiologists as being irrational and were associated with significant perioperative morbidity and mortality.3 The pressures of a lengthening lung transplantation waiting list led Cooper and colleagues to revisit this approach using modern techniques of intensive care and better
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