Can COPD Be Treated With Surgery?

A fellow caregiver asked...

Can COPD Be Treated With Surgery?

Expert Answer

Dr. Leslie Kernisan is the author of a popular blog and podcast at She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

Unfortunately, there are no easy surgical treatments for chronic obstructive pulmonary disease (COPD). Surgery is only considered when cases have progressed to stage IV, the most severe stage.

At this point, however, there are two types of surgery that are sometimes considered:

Lung volume reduction surgery (LVRS). Some patients with severe cases of COPD may benefit from lung volume reduction surgery (LVRS), in which the size of the damaged lungs is reduced by removing the damaged parts.

This is considered high-risk surgery. In the National Emphysema Treatment Trial, the first multicenter trial designed to evaluate this surgery in detail, the death rate during surgery was a relatively high 6 percent.

Studies have shown that LVRS is most likely to improve quality of life and decrease mortality in patients with emphysema that mainly affects the upper parts of their lungs, who also have low exercise capacity. In other patients with COPD, LVRS did not improve mortality, and in some cases it increased the risk of dying. For this reason, Medicare and some other insurance companies will only pay for LVRS under certain very specific conditions.

Lung transplant. For people with advanced COPD who are not likely to benefit from LVRS, lung transplantation is sometimes considered. This is also a very risky surgery, however. People who have lung transplants are also required to take immunosuppressant drugs indefinitely after their surgery.