Current evidence on the safety and efficacy of lung volume reduction surgery for advanced emphysema appears adequate to support the use of this procedure provided that the normal arrangements are in place for consent, audit and clinical governance.
Clinicians wishing to use lung volume reduction surgery for advanced emphysema should ensure that patients are fully informed about the risks of the procedure and the likelihood of deterioration in the longer term. Use of NICE's information for the public is recommended.
Patient selection is important because mortality is increased in patients with the most seriously compromised lung function. NICE has published a guideline on chronic obstructive pulmonary disease.
The procedure should be undertaken by a multidisciplinary team that includes a respiratory physician, specialists in pulmonary rehabilitation and a thoracic surgeon.