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Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-1723
Toma P. T.
Endoscopic lung volume reduction has developed rapidly only in the last 4 years, although early reports exist since 1966. Several techniques have been proposed and different principles are under investigation. These include the use of an one-way bronchial valves inserted via fiberoptic bronchoscopy to promote atelectasis, promotion of local atelectasis and fibrosis by bronchoscopic injection of polymers, bronchopulmonary fenestrations to enhance expiratory flow, and thoracoscopic plication or compression of emphysematous lung. The work done so far has at least demonstrated that the principles are valid, and that placing lung implants in patients with emphysema is easy and safe. However, the efficacy and the best criteria for deciding the lung area to treat and how to select the patients for treatment are not clear. It is probably too early to draw any conclusions on the clinical applicability of any of these methods. Randomized trials are ongoing and more research is needed.