In selected cases, surgical lung volume reduction (LVR) is necessary to improve lung function. The procedure is performed surgically or bronchoscopically (endoscopic lung volume reduction, ELVR).
Endoscopic lung volume reduction (ELVR) – removal of 20-30% of lung tissue in emphysema.
- Indication: advanced emphysema with an FEV1 (forced one-second capacity) of <40% and a residual volume (amount of breathing air permanently retained 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.
Further notes
- The benefit and harm analysis of the Institute for Quality and Efficiency in Health Care (IQWiG) can hardly make reliable statements due to fewer available studies on the bronchoscopic procedure. With regard to overall mortality (mortality), one of the following statements was made: “Looking at the data five years after the procedure, there is an indication of a benefit of surgical LVR”.
- In severe courses, lung transplantation (LUTX) may be discussed in special cases.
