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June 18, 1997

Lung Volume Reduction Surgery Puts a New Twist on an Old Technique

JAMA. 1997;277(23):1830-1831. doi:10.1001/jama.1997.03540470012005

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OVER THE last 3 years, a surgical technique resurrected from the 1950s has been proving a simple axiom: less can indeed be more.

Across the country, pulmonologists and thoracic surgeons have reported anecdotally and in small studies some remarkable improvements in patients with emphysema following lung volume reduction surgery.

In some patients, lung function as measured by the forced expiratory volume of air (FE V1) has improved by more than 80%. Others have been weaned from oxygen during physical exertion and at rest.

For Takoma Park, Md, pulmonologist Alfred Munzer, MD, the surgery meant a patient of his with emphysema could resume singing in her church choir after a 10-year absence. Another of Munzer's patients mortgaged his house to pay for the surgery and later deemed the cost well worth it.

"I was extremely skeptical in the beginning," Munzer said. But after witnessing the gains 5 of his patients