Surgical management of pulmonary emphysema: An update for primary care physicians

Abstract

Pulmonary emphysema is a major cause of chronic morbidity and mortality for which the traditional mainstay of management is medical palliation. However, advances in surgical technology have now given thoracic surgeons a major role to play in treating this disease. Lung volume reduction surgery is now proven to offer functional and survival benefit to selected patients with emphysema over medical therapy alone. The latest results from the National Emphysema Treatment Trial have conclusively demonstrated that such benefits are significant and long-lasting. More recently, endobronchial valve therapy for emphysema has been developed, promising effective functional improvements with minimal procedural morbidity. In Hong Kong, these surgical options for the treatment of emphysema are available in addition to lung transplantation. More than ever, the management of pulmonary emphysema should be regarded as a multidisciplinary effort, involving primary care physicians and thoracic surgeons as well as respiratory and rehabilitation physicians, to ensure that every therapeutic option is made available to patients.