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Endoscopic Approach for Colloid Cyst Resection
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Endoscopic approaches for treating emphysema.

Konstantina Kontogianni1,2, Ralf Eberhardt1,2

  • 1a Department of Pneumology and Critical Care Medicine , Thoraxklinik at University of Heidelberg , Heidelberg , Germany.

Expert Review of Respiratory Medicine
|June 24, 2018
PubMed
Summary
This summary is machine-generated.

Novel endoscopic techniques offer lung volume reduction for severe pulmonary emphysema, improving patient outcomes. These minimally invasive methods, including valve implantation and coil implantation, are safer alternatives to surgery.

Keywords:
Chronic obstructive pulmonary diseasebronchoscopyemphysemaendoscopic lung volume reductionhyperinflation

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Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Interventional Pulmonology

Background:

  • Severe pulmonary emphysema treatment traditionally involves high surgical risks.
  • Recent advancements include minimally invasive endoscopic lung volume reduction techniques.
  • These novel approaches aim to improve outcomes and reduce perioperative morbidity.

Purpose of the Study:

  • To review current blocking and non-blocking endoscopic techniques for lung volume reduction in emphysema.
  • To discuss patient selection criteria and potential complications associated with these procedures.
  • To evaluate the efficacy of these techniques based on available randomized controlled trials (RCTs).

Main Methods:

  • Systematic evaluation of all available randomized controlled trials (RCTs) on endoscopic lung volume reduction.
  • Categorization of techniques into blocking (e.g., valve implantation) and non-blocking (e.g., coil implantation, thermal vapor ablation, polymeric lung volume reduction).
  • Inclusion of targeted lung denervation as a novel approach.

Main Results:

  • Reversible valve implantation (blocking) is effective in patients with absent collateral ventilation, confirmed by RCTs.
  • Non-blocking techniques (coils, thermal vapor, polymeric reduction) are independent of collateral ventilation but have limited RCT data.
  • Targeted lung denervation aims for bronchodilation via nerve ablation.

Conclusions:

  • Endoscopic lung volume reduction offers promising alternatives to surgery for severe emphysema.
  • Patient selection is crucial, particularly for valve implantation based on collateral ventilation.
  • Further research is needed to optimize predictors of clinical outcome and minimize complications for improved safety and efficacy.