Our Summary

This research paper talks about a minimally invasive procedure called Bronchoscopic Lung Volume Reduction (BLVR) that can help patients with severe emphysema, a lung condition that causes shortness of breath. This procedure is particularly beneficial for patients who cannot undergo surgical lung volume reduction. BLVR has been found to enhance lung function and overall patient well-being, with a low risk of serious complications.

To determine whether a patient is suitable for BLVR, doctors use medication and other non-drug treatments, along with lung function tests and imaging studies. There are different techniques of performing BLVR, each with its own benefits and risks. These techniques can either block certain parts of the lung, using devices like endobronchial valves and intrabronchial valves, or they can involve non-blocking procedures such as endobronchial coils and bronchoscopic thermal vapor ablation.

The paper aims to present the various options of BLVR, and discuss their effectiveness and safety based on the data available.

FAQs

  1. What is bronchoscopic lung volume reduction (BLVR) and who are the ideal candidates for this procedure?
  2. What are the different types of BLVR techniques and their associated benefits and risks?
  3. How is the efficacy and safety of BLVR procedures determined?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions closely, including any medications to take or avoid, fasting guidelines, and any necessary tests or consultations. It is important to be in the best possible health before undergoing surgery to minimize risks and improve outcomes. Additionally, following post-operative instructions, such as taking medications as prescribed, attending follow-up appointments, and participating in rehabilitation programs, can also help to ensure a successful recovery.

Suitable For

Patients who are typically recommended for lung surgery are those with severe emphysema who have significant symptoms and impaired lung function despite optimal medical management. These patients may not be candidates for traditional surgical lung volume reduction due to comorbidities or other factors that make them high-risk for surgery. Radiographic and pulmonary function testing are used to help identify potential candidates for bronchoscopic lung volume reduction (BLVR) procedures.

Candidates for BLVR should have a thorough evaluation by a multidisciplinary team including pulmonologists, thoracic surgeons, and interventional pulmonologists. They should also have a strong understanding of the risks and benefits of the procedure. Patients with significant collateral ventilation, poor lung function, or other factors that may impact the success of the procedure may not be considered suitable candidates for BLVR.

Overall, patients recommended for lung surgery are those who have severe emphysema and significant symptoms despite optimal medical management, and who are deemed suitable candidates for bronchoscopic lung volume reduction based on a thorough evaluation of their individual circumstances.

Timeline

Before undergoing lung surgery, a patient typically undergoes a series of evaluations and tests to determine the best course of treatment. This may include consultations with a pulmonologist, thoracic surgeon, and other specialists, as well as imaging studies such as chest CT scans and pulmonary function tests. The patient may also undergo a period of preoperative preparation, which may involve quitting smoking, optimizing medications, and addressing any other medical conditions that could impact the surgery.

After lung surgery, the patient will typically spend some time recovering in the hospital, where they will be monitored closely for any complications. This may involve pain management, physical therapy, and respiratory therapy to help with breathing and lung function. The patient will also receive instructions on how to care for their incision site, manage any pain or discomfort, and gradually resume normal activities. Follow-up appointments with the surgical team will be scheduled to monitor the patient’s progress and address any concerns that may arise. Over time, the patient can expect to see improvements in their lung function and overall quality of life as they recover from the surgery.

What to Ask Your Doctor

  1. What is the specific type of lung surgery being recommended for me and how does it work to improve my condition?

  2. What are the potential risks and complications associated with this type of lung surgery?

  3. How long is the recovery time for this procedure and what can I expect during the recovery process?

  4. Will I need to make any lifestyle changes or take additional medications after the surgery?

  5. What are the expected outcomes of the surgery in terms of improving my lung function and quality of life?

  6. Are there any alternative treatments or procedures that could be considered instead of or in addition to the recommended surgery?

  7. How many times have you performed this type of surgery and what is your success rate with similar patients?

  8. Will I need any additional tests or evaluations before the surgery to ensure I am a suitable candidate?

  9. What follow-up appointments or monitoring will be necessary after the surgery to track my progress and address any potential complications?

  10. Are there any specific instructions or precautions I should follow before and after the surgery to optimize my recovery and outcomes?

Reference

Authors: Fernandez-Bussy S, Labarca G, Herth FJF. Journal: Semin Respir Crit Care Med. 2018 Dec;39(6):685-692. doi: 10.1055/s-0038-1676774. Epub 2019 Jan 14. PMID: 30641586