[Lung Volume Reduction Surgery in the Bronchoscopic Lung Volume Reduction Era:Reassessment of Indications and Strategies].

Bronchoscopic lung volume reduction( BLVR) and lung volume reduction surgery( LVRS) represent two complementary strategies in the management of advanced emphysema. BLVR has emerged as a minimally invasive and reversible approach, demonstrating significant clinical benefit in carefully selected patients without collateral ventilation, supported by advances in physiological assessment and imaging technologies. LVRS, by contrast, remains a well-validated surgical option offering sustained improvements in pulmonary mechanics, exercise tolerance, and quality of life, particularly in patients with heterogeneous upper-lobe predominant disease. Recent randomized trials have underscored the comparable efficacy of both modalities, highlighting the need for individualized, phenotype-driven treatment planning. A multidisciplinary, individualized approach is essential to optimize treatment selection.