Table of Contents
ISRN Pulmonology
Volume 2014 (2014), Article ID 418092, 17 pages
http://dx.doi.org/10.1155/2014/418092
Review Article

Lung Volume Reduction Surgery for Emphysema Treatment: State-of-the-Art and Perspectives

1Department of Thoracic Surgery, Policlinico Tor Vergata, V.le Oxford, 81, 00133, Rome, Italy
2Section of Medical and Surgical Lung Diseases, Department of Biomedicine and Prevention, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy

Received 21 November 2013; Accepted 2 January 2014; Published 9 March 2014

Academic Editors: M. Bonay, F. García-Río, K. Nishimura, and M. Nosotti

Copyright © 2014 Eugenio Pompeo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Lung volume reduction surgery (LVRS) has shown an improve for up to several years respiratory function, exercise capacity, and quality of life in selected patients with severe emphysema and low exercise capacity, particularly if upper-lobe predominance of disease is radiologically recognized. However, mortality and morbidity rates of LVRS have been not negligible leading to raising question as to the cost-effectiveness of the procedure and resulting in a progressive decline in its use although a considerable number of patients meet selection criteria and could potentially benefit of this treatment modality. In recent years, an active investigation aimed at developing less invasive strategies that might allow us to achieve long-term results as satisfactory as those of the standard LVRS method but with fewer adverse effects has been undertaken. So far, novel options including nonresectional surgical and endoscopic LVRS methods hold promise but results from large studies with long follow-up are awaited to help define the most effective interventional treatment options for patients with severe emphysema. In this literature review an analysis of the main issues related to LVRS including selection criteria, mechanisms of action, results of currently available surgical and endoscopic methods, and some potential future perspectives is provided.