Long-term results of patients treated with bronchoscopic lung volume reduction

Özet

Aims: Surgical and bronchoscopic treatments are tried to reduce hyperinflation togetherwith medical treatments in patients with chronic obstructive pulmonary disease (COPD) andemphysema. Therefore, bronchoscopic lung volume reduction (BLVR) procedures can improvethe success of treatment and quality of life of patients.Methods: We investigated the efficacy and safety of BLVR treatment retrospectively.Demographic characteristics, modified Medical Research Council (mMRC) and COPDassessment test (CAT) questionnaires, 6-minute walking distance (6-MWD) and all pulmonaryfunction tests of the patients, who were treated with BLVR, were examined. The values beforethe procedure and the values at the third and sixth months after the procedure were analyzedstatistically.Results: Twenty-five patients were examined (one was female). Six patients (59±10.4 years,forced expiratory volume in 1 s (FEV1) 21.7±5.7% pred) were bronchoscopically treated withcoils, with a median of 9.33 (range 8-11) coils per procedure. Nineteen patients (65.8±6 years,FEV1 26.9±9% pred) were treated with valves, with a median 3.52 (range 3-4) valves perpatient. At 3 and 6 months, respectively, ΔCAT was −4.8±6 and −7.5±7.2 points, Δ6-MWD was+103.4±139 m and +160.8±149 m [endobronchial valve (EBV)], ΔFEV1 was +0.15±0.3 L and+0.21±0.3 L, ΔFVC was +0.44±0.7 L and +0.5±0.7 L, (all p<0.05), and ΔRV (residual volume) was−0.52±1.1 L and 0.32±1.5 L (p˃0.05).Conclusions: In our study, BLVR (EBV and coil) treatments were used in patients with severeto very severe emphysema in COPD, in appropriate indications and in selected cases, andstatistically significant well-being was observed in spirometric parameters in the first sixmonths after the procedure.