Surgical strategy for lung volume reduction surgery

Lung volume reduction surgery (LVRS) has been a popular procedure since the early 1990s. It appears that there has developed a consensus in the litera ture that the ideal patient is one with evidence of marked hyperinflation a nd heterogenous disease. In this patient profile, LVRS has produced excelle nt results with respect to lung function and improved exercise tolerance. G eneral areas of controversy are discussed which include the role of lasers; unilateral versus bilateral procedures; the role of a staged unilateral pr ocedure; and which surgical route is best for patients. The existing litera ture is reviewed on these issues. (C) 1999 Elsevier Science B.V. All rights reserved.