Lung Volume Reduction Surgery

Emphysema is characterized by a reduced maximum expiratory flow due to a combination of airway disease and loss of elastic recoil. The latter leads to an increase in static pulmonary compliance, static and dynamic hyperinflation, intrinsic positive end-expiratory pressure, and increased work of breathing. Chronic hyperinflation also puts the muscles of respiration at a great mechanical disadvantage.

Lung volume reduction surgery (LVRS) is currently undergoing evaluation for the treatment of pulmonary emphysema. Recent studies have documented improved quality of life and relief of dyspnea in at least some patients. Proposed mechanisms of improvement after LVRS are increased elastic recoil, decreased airway resistance, and improved respiratory muscle function. order birth control online

There are few studies describing long-term follow-up in LVRS patients. It is theoretically possible that interaction within the lung due to inhomogeneous changes in elastic recoil and airway function could result in bulla formation. The following is a case report of the development of giant bullous disease following LVRS, and we postulate that improved elastic recoil contributed to this complication.