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Pulmonary emphysema is a common, progressive, disabling disease that carries a high mortality rate. It occupies one end of the spectrum of chronic obstructive pulmonary disease (COPD), with chronic bronchitis at the other end of the spectrum. Invariably, bronchitic disease is much more responsive to medical management than is emphysema. The inexorable progression of emphysema, accompanied by increasing breathlessness, renders the patient desperate for relief. Over the years, surgeons have responded to the call for help by developing operative procedures for different parts of the respiratory apparatus, including the chest wall, diaphragm, pleura, and nervous system. Although these procedures were
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