BRONCHOSCOPIC LUNG VOLUME REDUCTION/ ENDOSCOPIC EMPHYSEMA TREATMENT

Abstract

Chronic Obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality worldwide. It is not only the fourth leading cause of death but also leads to premature disability and is a major consumer of medical resources. This epidemic is widespread and far too common in Pakistan as it is responsible for 71 deaths per 100,000 making it the countries’ fourth leading cause of death. The abnormal and permanent enlargement of the terminal bronchioles and destruction of the alveolar units define emphysema. This destruction leads to a loss of the normal elastic recoil, which plays a role in air trapping and hyperinflation. Lung volume reduction surgery (LVRS or reduction pneumoplasty) has been shown to be a successful surgical treatment in selected patients with severe emphysema with demonstrated failure to standard medical therapy. However, surgical morbidity is high and non-pulmonary comorbiditiesmay preclude surgery. Given the potential for complications with LVRS anda limited pool of patients without limiting co-morbidities efforts for a minimally invasive procedure with the potential for similar outcomes have been underway. One such technique is Bronchoscopic Lung Volume Reduction (BLVRS or Endoscopic Emphysema Treatment). The rationale for this treatment lies in the theory that the use of a blocker, sealant, device or method of ablation would lead to collapse of the emphysematous portion of the lungs and the volume reduction would have similar results to surgical resection without the morbidity of surgical procedure