Interventionelle Bronchoskopie: was ist möglich und was ist sinnvoll?

Was ist neu?

Interventionelle Techniken bei Atemwegsstenosen Zu den interventionellen Techniken bei Atemwegsstenosen gehören nach wie vor die Ballondilatation, Kryotherapie, Lasertherapie, Argon-Plasma-Koagulation, Brachytherapie, fotodynamische Therapie und Stentimplantation. Die Auswahl der Therapieform wird in Abhängigkeit von Ausweitung und Entität des Tumors indiziert.

Endoskopische Lungenvolumenreduktion bei COPD Die endoskopische Lungenvolumenreduktion mittels Ventilimplantation oder Coilimplanation ist mittlerweile fester Bestandteil der COPD-Leitlinie. Endoskopische Thermoablation (BTVA) und polymerische Lungenvolumenreduktion (PLVR) sind weitere Therapieoptionen bei ausgewählten Patienten mit fortgeschrittenem Lungenemphysem.

Targeted Lung Denervation (TLD) Die TLD befindet sich für Patienten mit COPD und therapierefraktärem Asthma bronchiale in klinischer Untersuchung.

Thermoplastie bei Asthma bronchiale Die Thermoplastie ist das einzige etablierte endoskopische Verfahren bei therapierefraktärem Asthma bronchiale.

Kryospray-Therapie bei chronischer Bronchitis Für Patienten mit chronischer Bronchitis steht die Kryospray-Therapie zur Verfügung, deren Effektivität und Sicherheit ebenfalls im Rahmen von Studien überprüft wird.

Abstract

Interventional bronchoscopy plays a significant role in the treatment of various pulmonary diseases. Different endoscopic therapeutic modalities are available for the management of central airway obstruction (CAO) that represent a common indication for interventional bronchoscopy. The latest development in the field of CAO management are biodegradable stents, that would maintain the airway patency over time, then gradually degrade and vanish from the airway. Other indications for interventional bronchoscopy are chronic obstructive pulmonary disease (COPD), emphysema, asthma and chronic bronchitis. Thereby, various techniques of endoscopic lung volume reduction (ELVR) that address at hyperinflation reduction extend the therapeutic spectrum of patients with severe emphysema. Targeted lung denervation that aims a persistent bronchodilation present an area of current research in the field of COPD and asthma. In patients with chronic bronchitis, cryospray therapy that is performed within clinical trials may reduce the amount of secretion.

Schlüsselwörter

interventionelle Pneumologie - Bronchoskopie - Atemwegsstents - endoskopische Lungenvolumenreduktion

Key words

interventional pneumology - bronchoscopy - airway stents - endoscopic lung volume reduction

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