Lung volume reduction surgery in selected patients with severe emphysema: significant benefit with low peri-operative risk

Lung volume reduction surgery (LVRS) offers improvement in lung function, quality of life and even survival in patients with severe emphysema. Candidate selection is the key issue and should be performed at high volume centers with a multidisciplinary emphysema board. The technique reduces the hyperinflated lung by resecting the most destroyed emphysema parts. Regaining the shape of the diaphragma improves lung function. Nowadays video-assisted thoracoscopic surgery is the golden standard for LVRS. Besides low perioperative mortality and morbidity there are still concerns about the efficacy and safety of the procedure. This review outlines patient selection, technique and results of LVRS.