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Resectional lung volume reduction has proven to be superior to medical treatment in reducing dyspnoea and in increasing lung function, survival and quality of life in a very well selected, low risk group of hyperinflated patients with heterogeneous emphysema predominantly in the upper lobe. Nevertheless, this intervention is hampered by an important pulmonary (30%) and cardiovascular (20%) morbidity, mainly as a result of prolonged (.7 days) air leak, and a 5% risk of death as a result of thedoi:10.1183/09059180.00005810 pmid:20956200 fatcat:emdeqtjsc5f4nowey6rpm4dxym