Korean J Med.  2014 Apr;86(4):432-437.

Clinical Applications of Bronchoscopic Lung Volume Reduction for Patients with Severe Emphysema

• Park TS
• Lee SW

Abstract

Emphysema is a category of chronic obstructive pulmonary disease characterized by chronic airflow limitation and hyperinflation. Several decades ago, it was found that the surgical resection of emphysematous lung improved lung function and the long-term survival in patients with severe advanced emphysema. However, it was associated with substantial postoperative morbidity, such as persistent air-leak and mortality. Therefore, bronchoscopic lung volume reduction (BLVR) techniques have been developed to avoid these risks associated with surgery. Of these, endobronchial valves have been subject to the largest number of clinical trials. Endobronchial valves are unidirectional valves placed in the bronchus of the most hyperinflated lobe to block regional inflation, while allowing exhalation, leading to atelectasis of the target lobe. BLVR using endobronchial valves improves lung function, exercise tolerance, and symptoms. To obtain the maximum clinical benefits, it is important to select patients who have a complete lobar fissure and heterogeneous emphysematous lung involvement. Other bronchoscopic approaches are being developed to overcome these limitations.

Keyword

Emphysema; Chronic obstructive pulmonary disease; Lung volume reduction; Bronchoscopy

MeSH Terms

Bronchi
Bronchoscopy
Emphysema*
Exercise Tolerance
Exhalation
Humans
Inflation, Economic
Lung*
Mortality
Pneumonectomy*
Pulmonary Atelectasis
Pulmonary Disease, Chronic Obstructive