Surgical and bronchoscopic pulmonary function-improving procedures in lung emphysema

Abstract

COPD is a highly prevalent, chronic and irreversible obstructive airway disease without curative treatment. Standard therapeutic strategies, both non-pharmacological and pharmacological, have only limited effects on lung function parameters of patients with severe disease. Despite optimal pharmacological treatment, many patients with severe COPD still have a high burden of dyspnoea and a poor quality of life. If these patients have severe lung emphysema, with hyperinflation as the driver of symptoms and exercise intolerance, lung volume reduction may be an effective treatment with a significant impact on lung function, exercise capacity and quality of life. Currently, different lung volume reduction approaches, both surgical and bronchoscopic, have shown encouraging results and have been implemented in COPD treatment recommendations. Nevertheless, choosing the optimal lung volume reduction strategy for an individual patient remains challenging. Moreover, there is still room for improving durability of effect and safety in all available procedures. Ongoing and innovative research is essential to push this field forwards. This review provides an overview of results and limitations of the current lung volume reduction options for patients with severe lung emphysema and hyperinflation.

A preclinical animal study to evaluate the operability and safety of domestic one-way endobronchial valves

“…Bronchoscopic lung volume reduction (BLVR) refers to a technique developed to treat hyperinflation due to emphysema via a flexible bronchoscope, which causes atrophy and fibrosis of the target lung, resulting in regional lung volume reduction and achieving the same therapeutic goal as that of lung volume reduction surgery ( 15 , 16 ). One-way endobronchial valves (EBV) have been designed for bronchoscopic placement based on the hypothesis that they will allow air and mucus to exit the treated area but do not allow air to re-enter ( 17 ).…”