To the Editor:
Dr Denis O’Donnell’s review of the recent Canadian Thoracic Society guidelines for the management of chronic obstructive pulmonary disease was a worthwhile summary for primary care providers. However, it was surprising to see lung volume reduction surgery given such superficial treatment in the review. The opportunity for referral to a surgeon for consideration of this physiologically effective and life-prolonging treatment, although usually made by a respirologist, should not be taken away from primary care providers. Similar to smoking cessation and supplemental oxygen, lung volume reduction surgery is one of the very few proven treatments that offer survival benefit. It earned its own section in the guidelines, and it would have been worthy of more thorough discussion in the summary for primary care providers.
Sincerely,
Marcel Tunks MD
Resident, Respiratory Medicine
McMaster University
Hamilton, Ontario
D Miller MD FRCSC
Principal Investigator, Canadian Lung Volume Reduction Study
Professor, Thoracic Surgery
McMaster University
Hamilton, Ontario