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Endoscopic lung volume reduction in severe emphysema
Abstract
Therapeutic options in severe emphysema are limited. Endoscopic lung volume reduction (ELVR) refers to bronchoscopically inducing volume loss to improve pulmonary mechanics and compliance, thereby reducing the work of breathing. Globally, this technique is increasingly used as treatment for advanced emphysema with the aim of obtaining similar functional advantages to surgical lung volume reduction, while reducing risks and costs. There is a growing body of evidence that certain well-defined subgroups of patients with advanced emphysema benefit from ELVR, provided that a systematic approach is followed and selection criteria are met. In addition to endobronchial valves, ELVR using endobronchial coils is now available in South Africa. The high cost of these interventions underscores the need for careful patient selection to best identify those likely to benefit from such procedures.
Authors' affiliations
Coenraad Frederik N Koegelenberg, Pulmonology and Critical Care, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa
Johan Theron, Panorama Mediclinic, Cape Town, South Africa
J W Bruwer, Windhoek Mediclinic, Namibia
Brian W Allwood, Division of Pulmonology, Department of Medicine, Stellenbosch University of Tygerberg Academic Hospital, Tygerberg, Caoe Town, South Africa
Morné J Vorster, Division of Pulmonology, Department of Medicine, Stellenbosch University of Tygerberg Academic Hospital, Tygerberg, Caoe Town, South Africa
Florian von Groote-Bidlingmaier, Division of Pulmonology, Department of Medicine, Stellenbosch University of Tygerberg Academic Hospital, Tygerberg, Caoe Town, South Africa
Keertan Dheda, Lung Infection and Immunity Unit and Division of Pulmonology, Department of Medicine and UCT Lung Institute, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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Date published: 2015-09-14
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