RESPIRATORY
Endoscopic lung volume
reduction in COPD
In recent years, minimally invasive endoscopic lung volume reduction methods have become an
important option in the treatment of COPD patients with an emphysema phenotype
Aşkın Gülşen MD PhD
Department of
Pneumology, University
of Lübeck, Germany
Ayşe Pelin Girgin MD
Department of
Anesthesiology, Cigli
Education and Research
Hospital, Izmir, Turkey
Chronic obstructive pulmonary disease (COPD)
is a disease characterised by chronic airflow
limitation, and progressive and persistent
respiratory symptoms. 1 Today, COPD is the third
largest cause of mortality worldwide, and its
incidence increases gradually with smoking
status. 2 Emphysema is one of the subtypes of
COPD, and its treatment with standard drugs is
often difficult because of alveolar tissue damage,
loss of elastic recoil, air trapping and
hyperinflation. 3 Pulmonary function tests in
emphysema patients show increases in total lung
capacity (TLC) and residual volume (RV) in
addition to the classical COPD findings. Standard
treatment regimens for COPD normally include
smoking cessation, inhaler therapy, breathing
exercises, nutritional support, as well as oxygen
3
HHE 2019 | hospitalhealthcare.com
therapy and non-invasive ventilation in patients
with severe emphysema. 1 Unfortunately, these
treatments do not always yield satisfactory results
in patients with severe emphysema. In such
patients, hyperinflation, local air trapping and
intrathoracic compression are notable problems
that result in increased breathing difficulty and
place an additional burden on the respiratory
muscles.
There are, however, other treatment options
for patients with severe emphysema, such as lung
volume reduction surgery, bullectomy and lung
transplantation. 4 Surgery is only suitable for
selected patients due to intraoperative risks,
postoperative complications, and increased
mortality. 5 In the last decade, endoscopic methods
providing similar results to those of lung