Lung volume reduction surgery or bronchoscopic lung volume reduction: is there an algorithm for allocation?

Area of Science:

• Pulmonology
• Thoracic Surgery
• Respiratory Medicine

Background:

• Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global mortality.
• Air-trapping in COPD exacerbates respiratory and cardiac dysfunction, increasing morbidity and mortality.
• Reducing lung hyperinflation can significantly improve cardiopulmonary function.

Purpose of the Study:

• To review the selection criteria, risks, and benefits of surgical lung volume reduction (LVRS) and bronchoscopic lung volume reduction (BLVR).
• To provide guidance for treatment decisions in COPD patients based on current literature.

Main Methods:

• Review of current literature on LVRS and BLVR for COPD.
• Analysis of patient selection criteria, procedural risks, and reported benefits.
• Synthesis of evidence to inform treatment recommendations.

Main Results:

• LVRS has shown improvements in symptom burden and mortality in selected COPD patients with an emphysema phenotype.
• Minimally invasive BLVR techniques demonstrate improvements in lung function, dyspnea, and quality of life.
• Effective patient selection is critical for optimizing outcomes for both surgical and bronchoscopic interventions.

Conclusions:

• Lung volume reduction, through either surgical or bronchoscopic approaches, offers a viable treatment option for select COPD patients.
• BLVR provides a less invasive alternative with demonstrated benefits in lung function and quality of life.
• Evidence-based recommendations are essential for guiding the appropriate use of lung volume reduction therapies in COPD management.