Tratamiento endoscópico del enfisema

Severe pulmonary emphysema causes substantial morbidity and mortality. This disease can be treated with lung volume reduction surgery (LVRS) but only a subgroup of patients will derive a benefit and the procedure is not free of severe adverse effects. Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure without the adverse effects of LVRS. Due to its ease of use and effectiveness, the most commonly employed method is endobronchial valve placement through fiberoptic bronchoscopy under local anesthetic. Nevertheless, a subgroup of patients will not improve due to an increase in collateral ventilation. These patients may be suitable for BLVR using other techniques such as airway bypass through bronchial fenestration. Although studies performed with valves are encouraging, the results of two controlled multicenter studies should be known before this technique is implemented in clinical practice.