Chronic Obstructive Pulmonary Disease (COPD): Surgical Therapy

In some severe cases, surgical therapy may be indicated.

Possible surgical procedures for chronic obstructive pulmonary disease (COPD) include:

  • Bullectomy-removal of air sacs larger than 3 cm that have resulted from destruction of individual smaller air sacs (according to GOLD: Indication: lower lobe emphysema: Evidencce A).
  • Endoscopic lung volume reduction (ELVR) – removal of 20-30% of lung tissue for emphysema.
    • Indication: advanced emphysema with an FEV1 (forced one-second capacity) of <40% and a residual volume (amount of breathing air permanently held in the lungs, i.e., cannot be exhaled at will) of >200%.
    • Methods; reversible valve implantation; partially reversible coil implantation; irreversible bronchoscopic thermal ablation (BTVA).
    • Possible complications of:
      • Valve therapy: pneumothorax (collapse of the lung caused by an accumulation of air between the visceral pleura (lung pleura) and the parietal pleura (chest pleura)).
      • Coil implantation: hemoptysis (hemoptysis) and COPD exacerbations.
      • BTVA: inflammatory (“inflammatory”) reactions.
  • Lung transplantation (LUTX) – replacement of one or both lungs with a donor organ.