PURPOSE OF REVIEW Bronchoscopic lung volume reduction (BLVR) is a novel and effective treatment for a specific phenotype of chronic obstructive pulmonary disease (COPD) characterized by advanced emphysema with static lung hyperinflation and severe breathlessness. This review aims to provide an overview of the recent advances made in BLVR. RECENT FINDINGS For achieving optimal outcomes with BLVR, patient selection and target lobe identification is crucial. BLVR has recently also been established to improve pulmonary function, exercise capacity and quality of life in COPD patients falling outside the standard treatment criteria, including patients with moderate hyperinflation, chronic hypercapnic failure or with very low diffusion capacity. In a cluster analysis, target lobe characteristics like emphysema destruction, air trapping and perfusion were found to be important discriminators between responders and non-responders. A potential survival benefit has been demonstrated in BLVR-treated patients when compared to non-treated patients. Long-term outcomes showed sustained outcomes of BLVR; however, effects decline over time, probably due to disease progression. SUMMARY BLVR using one-way endobronchial valves has become a guideline treatment offered in specialized intervention centres for a specific subgroup of COPD patients. Recent studies further characterize responders, describe extrapulmonary effects of BLVR and show positive long-term outcomes and a potential survival benefit.

中文翻译：

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严重慢性阻塞性肺病患者支气管镜肺减容术的最新进展。

综述目的支气管镜肺减容术（BLVR）是一种新颖有效的治疗方法，用于治疗慢性阻塞性肺病（COPD）的特定表型，其特征是晚期肺气肿伴静态肺过度充气和严重呼吸困难。本综述旨在概述 BLVR 的最新进展。最近的发现 为了通过 BLVR 获得最佳结果，患者选择和目标叶识别至关重要。最近还建立了 BLVR，以改善不符合标准治疗标准的 COPD 患者的肺功能、运动能力和生活质量，包括中度过度充气、慢性高碳酸血症衰竭或弥散能力极低的患者。在聚类分析中，发现肺气肿破坏、空气滞留和灌注等靶叶特征是区分有反应者和无反应者的重要因素。与未接受治疗的患者相比，BLVR 治疗的患者具有潜在的生存获益。长期结果显示 BLVR 具有持续的结果；然而，效果会随着时间的推移而减弱，这可能是由于疾病进展。摘要 使用单向支气管内瓣膜的 BLVR 已成为专业干预中心为特定 COPD 患者亚组提供的指导性治疗。最近的研究进一步描述了反应者的特征，描述了 BLVR 的肺外效应，并显示出积极的长期结果和潜在的生存获益。