[Lung Volume Reduction Surgery - State of the Art 2016]

Area of Science:

• Pulmonary Medicine
• Thoracic Surgery
• Interventional Pulmonology

Background:

• Lung volume reduction surgery (LVRS) demonstrated benefits for advanced emphysema in mid-1990s case series.
• The National Emphysema Treatment Trial (NETT) confirmed LVRS efficacy, improving dyspnea, pulmonary function, and survival in selected patients.

Purpose of the Study:

• To review the efficacy of surgical and bronchoscopic lung volume reduction for advanced emphysema.
• To emphasize the critical role of patient selection and multidisciplinary care in emphysema treatment.

Main Methods:

• Review of large case series and randomized trials on lung volume reduction interventions.
• Analysis of patient selection criteria and treatment outcomes for emphysema.

Main Results:

• LVRS improves dyspnea, pulmonary function, and quality of life in advanced emphysema.
• Selected patients show increased survival post-LVRS; upper-lobe predominant heterogeneous emphysema is a key indication.
• Bronchoscopic lung volume reduction (BLVR) shows growing evidence of positive effects.

Conclusions:

• Patient selection at specialized centers with a multidisciplinary team is crucial for successful LVRS.
• Both surgical and bronchoscopic lung volume reduction methods are valuable components of multimodal emphysema treatment.