Surgical treatment of emphysema.

Patients breathless from chronic lung disease present a serious problem in morbidity and mortality in Britain, the U.S.A., and other countries with a temperate climate (Fletcher and Tinker, 1961 ; Bower, 1961). For their successful treatment it is essential to determine how much obstruction there is to the air-flow from their lungs and to try to find the cause of this obstruction, whether it be from bronchitis, asthma, or emphysema, or from some combination of these three commonest causes (Fletcher, Hugh-Jones, McNicol, and Pride, 1963). Though medical treatment can be effective in patients with labile air-flow obstruction from bronchitis and asthma, many patients are seen who are breathless, with "fixed" air-flow obstruction, associated with emphysema, which is unresponsive to bronchodilator drugs and is either found to remain after