Bilateral Bronchoscopic Lung Volume Reduction After Surgical Fissure Completion

Area of Science:

• Pulmonary Medicine
• Interventional Pulmonology
• Thoracic Surgery

Background:

• Bilateral lung volume reduction surgery (LVRS) is effective for emphysema.
• Bronchoscopic lung volume reduction (BLVR) with endobronchial valves is typically unilateral.
• BLVR is contraindicated in patients with interlobar collateral ventilation due to limited efficacy.

Observation:

• Two novel strategies were explored for lung volume reduction.
• These included bilateral BLVR and a combined surgical-interventional approach.
• The combined approach involved surgical fissure completion followed by endobronchial valve placement.

Findings:

• Both novel approaches achieved safe and effective bilateral lung volume reduction.
• Patients experienced excellent clinical outcomes.
• These methods expand treatment options for severe emphysema.

Implications:

• These techniques offer new possibilities for managing advanced emphysema.
• Bilateral BLVR and combined procedures may benefit patients previously ineligible for treatment.
• Further research can validate these approaches in larger cohorts.