PT - JOURNAL ARTICLE AU - Van Raemdonck, D. AU - Ninane, V. TI - Lung volume reduction for severe emphysema: do we need a scalpel or a scope? AID - 10.1183/09059180.00005810 DP - 2010 Sep 01 TA - European Respiratory Review PG - 242--247 VI - 19 IP - 117 4099 - https://publications.ersnet.org//content/19/117/242.short 4100 - https://publications.ersnet.org//content/19/117/242.full SO - EUROPEAN RESPIRATORY REVIEW2010 Sep 01; 19 AB - Resectional lung volume reduction has proven to be superior to medical treatment in reducing dyspnoea and in increasing lung function, survival and quality of life in a very well selected, low risk group of hyperinflated patients with heterogeneous emphysema predominantly in the upper lobe. Nevertheless, this intervention is hampered by an important pulmonary (30%) and cardiovascular (20%) morbidity, mainly as a result of prolonged (>7 days) air leak, and a 5% risk of death as a result of the surgical intervention. Results from ongoing randomised trials are awaited in order to determine whether less invasive, non-resectional lung volume treatment of emphysema via the bronchoscope using endobronchial valves, airway bypass stents or biological adhesives/heated water vapour will yield similar improvement with less morbidity and reduced mortality, compared with surgical resection. Furthermore, it is hoped that endoscopic lung volume reduction techniques may help patients with homogeneous emphysema currently excluded by most teams for the resectional procedure.