After the first operation, the patient was extubated in the operating room and had an uneventful course. He reported some, but not quite satisfactory, relief of dyspnea and chest tightness. Inspiratory vital capacity (IVC) and FEV1 were increased to 130% and 143% of the respective preoperative values, respectively (Table 1). Histologic examination of the resected lung specimens confirmed the diagnosis of constrictive bronchiolitis. Significant additional improvement was observed within days after the second LVRS. According to the boy’s own words, he could breathe much easier and his chest had assumed a much smaller, more comfortable size. This was confirmed by quantitative CT volumetry (Table 1, Fig 1
). Asynchrony of rib cage/abdominal motion was markedly reduced within a few days after surgery, and nearly normalized over the course of several weeks (Table 1, Fig 2
). One month after the second surgery, spirometry revealed IVC and FEV1 of 148% and 145% of respective preoperative values (Table 1). Further improvements were noted over the course of a few weeks. Body height had been stable and weight had decreased by 2 kg in the 8 months before surgery. In contrast, over the course of a few months after LVRS, the boy gained weight and resumed growth (Table 1). He was able to walk several hundred meters and to attended school again.