Bronchoscopic lung volume reduction by histoacryl

Abstract

Background Lung volume reduction can be accomplished by bronchoscopy, a procedure that represents a potential alternative to lung volume reduction surgery. The initial physical approach to bronchoscopic lung volume reduction (BLVR) was based on the simple concept that collapse of target regions could be initiated using a washout solution to disrupt the surfactant function and be maintained with a biocompatible ‘tissue sealant’ to prevent re-expansion. Aim The aim was to evaluate the safety and efficacy of BLVR using an adhesive material (histoacryl blue glue) in patients with emphysema and emphysematous bullae. Settings and design Prospective interventional analysis from two centers’ registry, namely The Bronchology Unit at Chest Department, Ain Shams University and The Bronchoscopy Unit of Kobry El Kobba Military Chest Hospital. Patients and methods The study included 40 patients having emphysema. All the patients had spirometry, arterial blood gases, 6 min walking test, and body plethysmography. All these tests were performed before and 90 days after the procedure. Results Residual volume decreased by 15.30% (P=0.567), forced expiratory volume in the first second increased by 11.43% (P=0.088), forced vital capacity increased by 22.92% (P=0.007), and 6-min walking distance increased by 70.39% (P=0.021). Postprocedure complications were minor with no mortality. Conclusion BLVR therapy using histoacryl blue glue is well tolerated and safe in patients with emphysematous bulla and diffuse emphysema. Treatment is associated with modest improvement in pulmonary function test values, increased exercise performance, and reduced dyspnea.