ABSTRACT
Since the initial reported success of lung volume reduction surgery (LVRS) in improving lung function, exercise performance, and quality of life in selected patients with emphysema (1-4), its application has been occasionally expanded to include chronic obstructive pulmonary disease (COPD) patients who have: (1) significant cardiovascular disease (5,6); (2) lung nodules (7-12), and sometimes those who are ventilator dependent (13-15). In addition, LVRS has also been applied successfully in surgical reduction of hyperinflation of the native lung in COPD patients after single-lung transplantation (16-19). All of these highly selective group of patients were considered for LVRS despite the presence of significant comorbidities, because their underlying prognosis was considered to be dismal without surgical treatment. In this chapter, we will review the extended indications for LVRS in these highly selective groups of COPD patients who receive LVRS under unique circumstances.
