Surgical and bronchoscopic pulmonary function-improving procedures in lung emphysema.

COPD is a highly prevalent, chronic and irreversible obstructive airway disease without curative treatment. Standard therapeutic strategies, both non-pharmacological and pharmacological, have only limited effects on lung function parameters of patients with severe disease. Despite optimal pharmacological treatment, many patients with severe COPD still have a high burden of dyspnoea and a poor quality of life. If these patients have severe lung emphysema, with hyperinflation as the driver of symptoms and exercise intolerance, lung volume reduction may be an effective treatment with a significant impact on lung function, exercise capacity and quality of life. Currently, different lung volume reduction approaches, both surgical and bronchoscopic, have shown encouraging results and have been implemented in COPD treatment recommendations. Nevertheless, choosing the optimal lung volume reduction strategy for an individual patient remains challenging. Moreover, there is still room for improving durability of effect and safety in all available procedures. Ongoing and innovative research is essential to push this field forwards. This review provides an overview of results and limitations of the current lung volume reduction options for patients with severe lung emphysema and hyperinflation.
Competing Interests: Conflict of interest: S. Everaerts, C.M. Vandervelde and P. Shah have no conflicts of interest related to the content of the manuscript. D-J. Slebos reports grants or contracts, study material, registration fees and travel costs, and participation on a Data and Safety Monitoring Board for Pulmonx, Corp., BTG/PneumRx Inc, FreeFlowMedical, Nuvaira, PulmAir, GALA, CSA Medical and Apreo, most of them paid to his institution. L.J. Ceulemans received an unrestricted university chair from Medtronic and a philanthropic grant from Gunze.
(Copyright ©The authors 2023.)