[Lung volume reduction surgery in treatment of diffusion pulmonary emphisema in case of chronic obstructive pulmonary disease].

Lung volume reduction surgery (LVRS) has become a palliative surgical method for selected patients with advanced pulmonary emphysema and disabilitating dyspnea The beneficial effects have been documented by numerous case series and by several randomized controlled trials. In well-selected patients the perioperative mortality does not exceed more than 5% in experienced centers and the expected improvement in FEV1 is a range of 30-60% at 3 to 6 months. Thereafter the lung function steadily declines, but the effect lasts for up to 4 to 6 years. Different approaches and surgical techniques are carried out, and most of the authors recommend bilateral lung volume reduction by video-assisted thoracic surgery. This therapeutic option was used alternatively in patients who were suitable candidates for lung transplantation, and several groups could demonstrate that transplantation could be postponed by 2 to 4 years after bilateral LVRS. The procedure itself does not jeopardize the chances for subsequent successful transplantation.