Endoskopische Therapie bei schwerer COPD – Eine neue Option zur Reduzierung der Lungenüberblähung

Seit 10 Jahren stellt die endoskopische Lungenvolumenreduktion als minimal-invasives Verfahren eine Therapieoption für Patienten mit einem fortgeschrittenen Lungenemphysem dar. Es können mittlerweile verschiedene Techniken unterschieden werden. Während hingegen die Implantation von Einweg-Ventilen eine effektive Behandlung bei Patienten mit geringer interlobärer Kollateralventilation ist, sind die Coils-Implantation, die polymerische Lungenvolumenreduktion sowie die bronchoskopische Thermoablation unabhängig von einer Kollateralventilation. All diese Verfahren verfolgen das Ziel, die Lungenüberblähung zu minimieren, wodurch es zur Verbesserung der Lungenfunktion, der Belastbarkeit und Lebensqualität kommt. Darüber hinaus scheint eine erfolgreiche Lungenvolumenreduktion mit einem Überlebensvorteil assoziiert zu sein.

Since 10 years the endoscopic lung volume reduction presents as minimal invasive procedure an effective treatment for patients with advanced emphysema. Different techniques of endoscopic lung volume reduction are available. While implantation of one-way valves are en effective therapy for patients with low interlobar collateral ventilation, the implantation of coils, the polymeric lung volume reduction and bronchoscopic thermal vapor ablation are independent of collateral ventilation. All these techniques have the aim to minimize hyperinflation thus leading to improvement of pulmonary function, exercise capacity and quality of life. Furthermore, a successful lung volume reduction seems to be associated with survival benefit.

Key words

Emphysema - hyperinflation - endoscopic lung volume reduction - collateral ventilation

• Literatur

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