중증 폐기종 환자에서 내시경적 폐용적 축소술의 임상 적용
Clinical Applications of Bronchoscopic Lung Volume Reduction for Patients with Severe Emphysema
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초록
Emphysema is a category of chronic obstructive pulmonary disease characterized by chronic airflow limitation and hyperinflation. Several decades ago, it was found that the surgical resection of emphysematous lung improved lung function and the long-termsurvival in patients with severe advanced emphysema. However, it was associated with substantial postoperative morbidity, such aspersistent air-leak and mortality. Therefore, bronchoscopic lung volume reduction (BLVR) techniques have been developed toavoid these risks associated with surgery. Of these, endobronchial valves have been subject to the largest number of clinical trials. Endobronchial valves are unidirectional valves placed in the bronchus of the most hyperinflated lobe to block regional inflation,while allowing exhalation, leading to atelectasis of the target lobe. BLVR using endobronchial valves improves lung function,exercise tolerance, and symptoms. To obtain the maximum clinical benefits, it is important to select patients who have a completelobar fissure and heterogeneous emphysematous lung involvement. Other bronchoscopic approaches are being developed toovercome these limitations.
Abstract
Emphysema is a category of chronic obstructive pulmonary disease characterized by chronic airflow limitation and hyperinflation. Several decades ago, it was found that the surgical resection of emphysematous lung improved lung function and the long-termsurvival in patients with severe advanced emphysema. However, it was associated with substantial postoperative morbidity, such aspersistent air-leak and mortality. Therefore, bronchoscopic lung volume reduction (BLVR) techniques have been developed toavoid these risks associated with surgery. Of these, endobronchial valves have been subject to the largest number of clinical trials. Endobronchial valves are unidirectional valves placed in the bronchus of the most hyperinflated lobe to block regional inflation,while allowing exhalation, leading to atelectasis of the target lobe. BLVR using endobronchial valves improves lung function,exercise tolerance, and symptoms. To obtain the maximum clinical benefits, it is important to select patients who have a completelobar fissure and heterogeneous emphysematous lung involvement. Other bronchoscopic approaches are being developed toovercome these limitations.
참고문헌 (17)
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