Lung volume reduction surgery (LVRS) as well as bronchoscopic lung volume reduction (BLVR) provide functional improvements in selected patients with homogenous emphysema and pronounced hyperinflation. A direct comparison of LVRS and BLVR in patients with homogenous emphysema is not available, thus the study will provide important data to guide treatment selection in this patient population.
Optimal medical therapy for \> 3months, sufficient rehabilitation status with no need for further training/rehabilitation or rehabilitation within 6 months prior to intervention.
Body Mass Index (BMI) \> 18, but \< 35 kg/m2
Daily dose of prednisone ≤ 10mg
You may not be if
Contraindication against either LVRS or BLVR and/or to surgery and bronchoscopy in general
Major comorbidities limiting survival
Age ≥ 80 years
Nicotine abuse within 3 months (documented by cotinine testing)
Predominance of either left or right lung of \>70% in perfusion SPECT scintigraphy
