News on lung volume reduction surgery

Lung volume reduction surgery (LVRS) is an established therapeutic option for patients with advanced pulmonary emphysema after all conservative measures, including comprehensive pulmonary rehabilitation, have been exhausted. LVRS improves pulmonary function, shortness of breath, exercise capacity and hence quality of life in some 80% of cases for up to four years. Even patients with homogeneous types of pulmonary emphysema improve if those with extremely low FEV1 and/or very low diffusion capacity are excluded. At experienced centres perioperative mortality is less than 2% in appropriately selected patients, and current results suggest that the five-year survival in COPD patients may even be improved by this palliative surgical intervention. In patients under 60 LVRS may serve as a bridging procedure to lung transplantation. Bronchoscopic creation of extra-anatomic bronchopulmonary passages - endoscopic LVRS - is a novel approach now under investigation.