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Lung volume in COPD: when less is more
  1. Jo Congleton, DTB Associate Editor
  1. Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Dr Jo Congleton, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK; jo.congleton{at}

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For over 25 years, there has been little change in the treatment of chronic obstructive pulmonary disease (COPD). Despite interest in ‘personalised medicine’, applying phenotyping to COPD management is currently not part of routine care. However, for patients with emphysema-predominant disease, lung volume reduction procedures are a potential specific treatment. Lung volume reduction surgery (LVRS) was first carried out in the 1950s but did not gain credence, largely due to high surgery-related mortality (16%).1 Joel Cooper, an American surgeon, revisited the technique in the 1990s and reported improved lung function, improved exercise tolerance and 1-year all-cause mortality of 5%.2 This sparked renewed interest.

The basic principle of lung volume reduction is to reduce hyperinflation secondary to emphysema. Hyperinflation leads to the respiratory muscles (diaphragm and …

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  • Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).

  • Provenance and peer review Commissioned; externally peer reviewed.