It is fairly common for COPD patients to need major surgery at some point. A significant number of them have developed lung cancer, as it shares COPDs and cardiovascular disease's kinship to smoking. A number of other conditions typically associated with advancing age also require surgery.

It used to be that COPD and surgery were a very lethal combination. But light years of progress have been made in the decades since the 1950s and 1960s: improved surgical techniques, commonplace forms of breathing support and cardiac monitoring that weren't even available then, plus pharmacology advances. So surgery itself is far more effective, and pre-and postoperative care of critically ill patients has vastly improved. That is why there are patients with serious pulmonary disease now undergoing surgery much more frequentlyand much more safely.

When a COPD patient develops a condition requiring surgical treatment, his doctor has to weigh the benefits of surgery against the complications it might provoke. In assessing the nature and likelihood of risk, his doctor must consider what is known about the particular procedure's impact on COPD, and try to estimate the chance of pulmonary complicationspossibly leading to deathfollowing surgery. But there is often precious little to guide him in this