Lung volume reduction: surgery versus endobronchial valves

Volume reduction is a disease-modifying treatment that aims to reshape the diseased lung towards a more normal total lung capacity by removing severely damaged and overinflated lung parenchyma. It is an effective therapeutic strategy in well-selected patients, resulting in improvements in exercise tolerance, lung function, quality of life and survival. The most widespread strategies for volume reduction are either video-assisted thoracoscopic surgery or bronchoscopic lung volume reduction. It is crucial to decide which approach would be more suitable for specific patients, as this is related to the outcome of the procedure. Factors like emphysema distribution on computed tomography, the presence or absence of collateral ventilation, the patient's pulmonary function tests, a history of other comorbidities and previous interventions might all influence the choice of procedure. It is crucial that this decision is taken by a multidisciplinary expert team to have the best outcome and fewer complications.