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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.<\/jats:p>","DOI":"10.1183\/16000617.0004-2023","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T09:41:11Z","timestamp":1703065271000},"page":"230004","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Surgical and bronchoscopic pulmonary function-improving procedures in lung emphysema"],"prefix":"10.1183","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2646-4770","authenticated-orcid":false,"given":"Stephanie","family":"Everaerts","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle M.","family":"Vandervelde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9052-4638","authenticated-orcid":false,"given":"Pallav","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-3422","authenticated-orcid":false,"given":"Dirk-Jan","family":"Slebos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens J.","family":"Ceulemans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2023,12,20]]},"reference":[{"key":"2024102404154036000_32.170.230004.1","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"8","author":"Soriano","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2024102404154036000_32.170.230004.2","unstructured":"WHO Department of Data and Analytics . 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