Surgical and Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Systematic Review and Network Meta-Analysis

This meta-analysis compares different lung volume reduction techniques for patients with severe emphysema. Analyzing data from 25 randomized controlled trials with 4,283 patients, the study found that lung volume reduction surgery (LVRS) provided the most significant improvement in pulmonary function, exercise capacity, and quality of life, although it was associated with an increased risk of mid-term mortality. Among the bronchoscopic options, endobronchial valves (EBV) and endobronchial coils (EBC) showed moderate efficacy in improving lung function but also carried risks, including pneumothorax and a slight increase in mortality with EBV. 
 
This study provides an evidence-based comparison of surgical and bronchoscopic lung volume reduction strategies, thereby helping to refine patient selection and guide clinical decisions to optimize outcomes in emphysema management.