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[Comment] Endobronchial valves in a highly parsed emphysema population

Lung volume reduction surgery is a thoracic surgical procedure whereby the hyperexpanded lungs of patients with severe emphysema are reduced in size by surgical excision of, ideally, the areas that are most severely destroyed.1,2 This operation, usually done bilaterally and almost always by video-assisted thoracoscopy, substantially improves pulmonary function, dyspnoea, and quality of life in appropriately selected patients. Several clinical series show about a 50% mean improvement in forced expiratory volume in 1 s (FEV1),3 and increased survival has been shown in one subgroup of patients.