Smokers' Second Wind?

It's the kind of surgery you would never expect most people with emphysema — a degenerative, often smoking-related condition of the lungs — to agree to undergo. Called lung-volume reduction, the operation is designed to decrease the capacity of the lungs in an attempt to improve their overall efficiency. In 1996 the National Institutes of Health decided to put the controversial operation to the test. The conclusion, published last week: the surgery can help some emphysema sufferers breathe more easily and improve their quality of life. Of the 1,218 patients in the study, researchers found that those who were too ailing to exercise and whose emphysema was located mostly in the upper lobes of the lungs benefited most. One year after surgery, 30% of those patients showed improved exercise capacity, while none of the nonsurgical patients did. Surgery also lowered those patients' death rate. Others, who were relatively better able to exercise and whose emphysema was primarily in the lower lobes of their lungs, did not fare as well. They died at twice the rate of their nonsurgical counterparts.