Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • Medical Jobs
  • Medical Matrimony
  • MD Brand Connect
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • MCI News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Aborad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • MCI News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Aborad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Surgery
  • Surgery News
  • lung volume reduction...

lung volume reduction surgery as good as bronchoscopic lung volume reduction surgery for treating emphysema

Dr. Kamal Kant KohliWritten by Dr. Kamal Kant Kohli Published On 2022-09-08T09:45:47+05:30  |  Updated On 2022-09-08T15:16:04+05:30
lung volume reduction surgery as good as bronchoscopic lung volume reduction  surgery for treating emphysema

Lung volume reduction surgery is an invasive operation as it requires a small incision to be made in chest, which is stitched up after the procedure. Researchers have conducted first randomised controlled trial to compare two different lung volume reduction procedures for people with emphysema. The results of the trial have revealed that both lead to similar improvements in lung...

Lung volume reduction surgery is an invasive operation as it requires a small incision to be made in chest, which is stitched up after the procedure. 

Researchers have conducted first randomised controlled trial to compare two different lung volume reduction procedures for people with emphysema. The results of the trial have revealed that both lead to similar improvements in lung function, breathlessness and exercise capacity. The findings of the study should help doctors and patients to choose the best approach to treat emphysema.

The results from the study of lung volume reduction surgery (LVRS) and bronchoscopic lung volume reduction (BVLR) have been presented at the European Respiratory Society International Congress in Barcelona, Spain.

Emphysema is a chronic lung disease, which is usually caused by smoking. The walls of the air sacs (alveoli) in the lung weaken and disintegrate, leaving behind abnormally large air spaces that remain filled with air even when the patient breathes out. Symptoms include breathlessness, coughing, fatigue and weight loss. In people where the lung damage is unevenly distributed, treatment to target the worst area of emphysema, by reducing the volume of the lung by about 20-30%, can improve airflow and exchange of gases in the alveoli in the remaining portions of the lungs.

LVRS involves a keyhole operation into the chest in order to access the lungs and remove the areas of the lungs most affected by emphysema. With BVLR, the procedure is carried out using a fibre optic camera which is inserted into the lungs via the mouth or nose. One-way valves (endobronchial valves) are placed into the airways leading to the targeted lobe of the lung, causing it to deflate almost completely.

Ms Sara Buttery, a research physiotherapist and PhD candidate at the National Heart and Lung Institute, Imperial College London (UK), told the Congress: "Both procedures have been shown to produce positive results in terms of lung function, breathlessness, exercise capacity and quality of life. Until now there had been no direct comparison of the two to inform decision-making when a person seems to be suitable for either. Bronchoscopic lung volume reduction is a less invasive option and is thought to be 'less risky' but, until now, there has not been substantial research to support this."

In the CELEB trial [2], Ms Buttery and colleagues randomised 88 patients with an average age of 64 years to receive either LVRS (41 patients) or BLVR (47 patients) and they followed them for a year to study the outcomes. They measured patients' response to treatment using the iBODE score.

This score incorporates four commonly used measures: body mass index, airflow obstruction, breathlessness (dyspnoea) and exercise capacity. They also looked at change in the residual volume (RV%), which provides a measure of the amount of 'gas-trapping' where excess air is left in the patient's lung even after fully exhaling.

"Both groups improved to a similar extent one year after treatment. Surgery and valve treatment produced similar reductions in gas trapping and similar improvements both in the total iBODE score, and in each of the individual measures that it is made up of," said Ms Buttery. "Both treatments also appeared to be equally safe, with only one death in each arm of the trial after a year, despite this being a population with severe lung disease.

"The results of this study will be important for clinicians and patients in guiding decision-making around which treatment option to choose when a person is suitable for either approach, providing more evidence around expected outcomes and risks."

Information from computerised tomography (CT) scans, the person's overall health, whether or not they have other, significant medical conditions, and whether they have frequent flare-ups of their condition, as well as individual preference, all contribute to the decision about whether a lung volume reduction procedure is best for them and which approach might be favoured.

Results can vary between patients after either procedure but they should be able to do more, with fewer symptoms.

"For example, they might be able to play with grandchildren, walk up a flight of stairs without having to sit down to recover, or be able to walk a mile without having to stop. We often say to people who are considering these treatments that they could expect to turn the clocks back two or three years to how their symptoms were at that point in time," she said.

Ms Buttery said that although this study rejected the hypothesis that surgery was substantially more effective than valve treatment, further research was needed in larger studies to see if individuals who respond especially well to one or other approach could be identified. The cost benefit of the two procedures should be investigated as well.

Dr Alexander Mathioudakis is NIHR Clinical Lecturer in Respiratory Medicine at the University of Manchester and Secretary of the ERS Airway Pharmacology and Treatment Group and was not involved in the research. He said: "The results from this first randomised controlled trial suggest that BVLR may be a good therapeutic option for those patients for whom either procedure is suitable.

Lung volume reduction surgery has risks associated with surgery and it takes longer to recover from than bronchoscopic lung volume reduction. On the other hand, endobronchial valves placement is also associated with side effects, such as pneumonia, or valve displacement. Therefore, both the safety and effectiveness of the two procedures need to be investigated further, in larger groups of patients, but the results from this trial are very encouraging."

Reference:

Sara Buttery, Samuel V Kemp, Pallav L Shah, David Waller, Simon Jordan, John T Lee, Winston Banya, Michael C Steiner, Nicholas S Hopkinson, BMJ Open. 2018; 8(10): e021368. Published online 2018 Oct 17. doi: 10.1136/bmjopen-2017-021368

BMJ Open emphysema lung volume invasive surgery bronchoscopic valve placement chronic lung disease surgical procedures CT scans 
Source : BMJ Open
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Before Joining Medical Dialogues, he has served at important positions in the medical industry in India including as the Hony. Secretary of the Delhi Medical Association as well as the chairman of Anti-Quackery Committee in Delhi and worked with other Medical Councils in India. Email: editorial@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story
    Similar Posts
    NO DATA FOUND

    Editorial

    Journal Club Today

    Health News Today

    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok