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:
- Lung transplantation (LUTX) – replacement of one or both lungs with a donor organ.