Our Summary

This paper looks at a treatment for severe emphysema called Endoscopic Lung Volume Reduction (ELVR). ELVR involves different techniques that vary in how they work, their reversibility, and safety. For this treatment to be successful, patients need to be carefully selected based on their lung function, the spread of their emphysema, and their collateral ventilation (the alternative flow of air within the lungs). So far, there have been only a few controlled studies on using bronchoscopic treatments (treatments involving a thin tube inserted into the lungs) for people with chronic obstructive pulmonary disease. Therefore, the use of these techniques should be carried out in clinical trials or registry studies.

FAQs

  1. What is endoscopic lung volume reduction (ELVR) and how does it help patients with advanced emphysema?
  2. What are the prerequisites for a successful use of the various ELVR techniques?
  3. Why should the various ELVR techniques be performed within clinical trials or registry studies?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions carefully, including fasting before surgery and stopping certain medications as instructed. It is also important to continue following post-operative instructions, such as taking prescribed medications, attending follow-up appointments, and participating in pulmonary rehabilitation programs to aid in recovery. Additionally, it is important to communicate any concerns or changes in symptoms to your healthcare provider immediately.

Suitable For

Patients with advanced emphysema who have severe symptoms and poor lung function are typically recommended for lung surgery, such as endoscopic lung volume reduction (ELVR). Precise patient selection is essential, taking into consideration pulmonary function test results, emphysema distribution, and collateral ventilation. ELVR techniques should be performed within clinical trials or registry studies due to limited randomized controlled trials in this patient population.

Timeline

Before lung surgery:

  1. Patient is diagnosed with advanced emphysema and is assessed by a pulmonologist.
  2. Pulmonary function tests are conducted to evaluate lung function and determine the severity of the emphysema.
  3. Imaging studies such as CT scans are performed to assess the distribution of emphysema in the lungs.
  4. Patient undergoes a thorough evaluation to determine their eligibility for endoscopic lung volume reduction (ELVR) surgery.
  5. Patient and healthcare team discuss the risks and benefits of the surgery, and a treatment plan is developed.

After lung surgery:

  1. Patient undergoes ELVR surgery, which may involve different techniques such as bronchoscopic lung volume reduction or endobronchial valves.
  2. Patient is closely monitored in the hospital post-surgery for any complications or side effects.
  3. Patient undergoes pulmonary rehabilitation to improve lung function and overall physical conditioning.
  4. Follow-up appointments are scheduled with the pulmonologist to monitor recovery progress and adjust treatment as needed.
  5. Patient continues to follow a treatment plan that may include medications, lifestyle changes, and regular monitoring of lung function to manage their emphysema.

What to Ask Your Doctor

  1. What are the potential benefits and risks of undergoing lung surgery for my condition?

  2. How will the specific type of lung surgery you are recommending help improve my symptoms and quality of life?

  3. What is the success rate of the procedure you are recommending and what is the typical recovery time?

  4. Are there any alternative treatments or less invasive options available for my condition?

  5. What are the potential complications or side effects of the surgery and how will they be managed?

  6. How many times have you performed this specific type of lung surgery and what is your success rate?

  7. Will I need to undergo any additional tests or procedures before the surgery?

  8. How long will I need to stay in the hospital after the surgery and what will my recovery process look like?

  9. Will I need any special accommodations or lifestyle changes after the surgery?

  10. What is the long-term outlook for my condition after undergoing lung surgery?

Reference

Authors: Gompelmann D, Herth FJ. Journal: Thorac Surg Clin. 2016 May;26(2):177-86. doi: 10.1016/j.thorsurg.2015.12.006. PMID: 27112257