Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Washington 98195-06522, USA. benditt@u.washington.edu
Surgical procedures designed to improve pulmonary function and quality of life of patients with advanced emphysema have been attempted for more than a century. Of the many attempted procedures, only giant bullectomy, lung transplantation, and lung-volume-reduction surgery have withstood the test of time and are currently being practiced. This article reviews each of these procedures and also develops a rational approach to selecting appropriate candidates for these 3 interventions.