History of surgery for emphysema

Abstract

Throughout the 20th century, several operations have been advocated as methods of treatment for patients with emphysema and, often, they were promoted as offering potential cures. Unfortunately, most of these procedures attempted to treat the wrong physiological or anatomic deficit so that mid- or long-term results were unpredictable or frankly disastrous. Procedures such as costochondrectomy were designed to permit further enlargement of the lungs, whereas thoracoplasty was designed to reduce lung volume. Operations were performed to restore the curvature of the diaphragm or devised to increase blood supply to the lung. Almost every thoracic structure including chest wall, diaphragm, pleura, nerves, airways, lung, or esophagus became "at risk" for surgical intervention. Short of bullectomy for emphysematous bullous lung disease and perhaps volume reduction for diffuse emphysema, none of these procedures has stood the test of time.