Mechanisms of improvement following lung volume reduction surgery

In the earliest reports of lung volume reduction surgery (LVRS) for emphysema, Brantigan et al. (1) claimed short-term symptomatic benefits but reported no objective findings. They cited Laennec, who had speculated that a procedure that could diminish alveolar distension would lessen the problems of hyperinflation (2). Brantigan suggested three mechanisms to explain the improvement after LVRS: increased radial traction on the airways, restoration of more normal configuration of respiratory muscles, and increased recoil of the lung. Forty years of research have not proved Laennec was incorrect, but have expanded greatly on his speculations.