Chirurgische oder bronchoskopische Lungenvolumenreduktion zur Emphysemtherapie

Bereits vor über 20 Jahren hat sich die chirurgische Lungenvolumenreduktion (LVRS) bei Patienten mit fortgeschrittenem Lungenemphysem als palliative Therapieoption etabliert, die die Atemnot verringert und die Lungenfunktion und Lebensqualität verbessert. Seit gut 10 Jahren existieren darüber hinaus bronchoskopische Verfahren (BLVR) mit dem Ziel einer Volumenreduktion. Die Vor- und Nachteile von LVRS und BLVR werden in diesem Beitrag diskutiert.

Abstract

More than 20 years ago, surgical lung volume reduction (LVRS) was already established in patients with advanced emphysema as a palliative therapy option that reduces respiratory distress and improves lung function and quality of life. In addition, bronchoscopic procedures (BLVR) aimed at volume reduction have existed for just over 10 years. The advantages and disadvantages of LVRS and BLVR are discussed in this article.

Kernaussagen

• Die LVRS bietet geeigneten Patienten mit COPD und schwerem Emphysem eine deutliche Verbesserung der Atemnot, Lungenfunktion und Lebensqualität.

• Die BLVR zeigt bis jetzt nicht nur funktionell gute Ergebnisse, sondern kann auch eine Therapieoption bei Patienten sein, die chirurgisch aufgrund mangelnder Operabilität nicht mehr behandelt werden können.

• Essenziell ist die interdisziplinäre Beurteilung des Patienten an erfahrenen Zentren.

• Die Patientenselektion und das Abschätzen des Resektionsausmaßes bleiben Herausforderungen.

• Die BLVR ist nicht als Konkurrenz zur LVRS, sondern als Ergänzung in der multidisziplinären Behandlung des Emphysempatienten einzuschätzen.

Schlüsselwörter

Lungenvolumenreduktion - LVRS - BLVR - chronisch-obstruktive Lungenerkrankung - Emphysem

Keywords

lung volume reduction - LVRS - BLVR - chronic obstructive pulmonary disease - emphysema

Publication History

Article published online:
21 August 2023

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