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Bronchoscopic Lung Volume Reduction Benefits and Risks

What you'll learn on this page:

Overview

Bronchoscopic lung volume reduction is a minimally invasive procedure for patients with severe emphysema. This means BLVR involves no incisions or stitches. As opposed to lung volume reduction surgery (LVRS), bronchoscopic lung volume reduction has many benefits, such as a shorter recovery time and the ability to be reversed in the case of complications. The goal of both BLVR and LVRS are to improve lung function for patients with emphysema. 

The benefits and risks of BLVR can include:

Benefits of BLVR Risks of BLVR
Improved lung function COPD exacerbation (sudden flare-ups)
Improved exercise tolerance Respiratory failure
Better quality of life Pneumothorax
Reversible Pneumonia
Lower risk of lung injury and infection  
Faster recovery time  

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Benefits

Improved breathing is the main benefit of bronchoscopic lung volume reduction (BLVR). Other benefits include:

Reduction in respiratory symptoms

Most patients have less shortness of breath following BLVR. This allows them to improve performing their daily activities.

Improved lung function

Sealing off diseased parts of the lungs with endobronchial valves allows healthier parts to expand and function better. This often leads to easier breathing after BLVR.

Ability to exercise more

Most people can exercise more easily and more often after BLVR. Increased exercise means more health benefits for your lungs and the rest of your body.

Better quality of life

Breathing easier allows you to live a more normal, active life. Many things you couldn’t do before – like shopping or exercising – may be possible after BLVR.

Reversible

BLVR is reversible, while LVRS is not. This allows you to change your mind if there are any complications after the procedure.

Lower risk of infection

BLVR is minimally invasive, which means there are no incisions or stitches involved. This greatly lowers the chance of infection and other complications that can arise from open surgery.

Faster recovery time

Because BLVR is minimally invasive, recovery time from the procedure is much shorter and virtually painless. In general, recovery from BLVR takes several days to weeks as opposed to LVRS, which can take several months.

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Risks and Complications

Every medical procedure has risks. Some of the complications that may occur with BLVR include:

Worsening of COPD symptoms

In a very small number of patients, COPD symptoms may worsen after BLVR. This can include difficulty breathing or a fast heartbeat.

Respiratory failure

Respiratory failure is a serious problem that occurs when the exchange of oxygen and carbon dioxide in the lungs doesn’t occur. This rare complication from BLVR can lead to greater difficulty breathing.

Pneumonia

Because it is minimally invasive, BLVR carries a much lower risk of infection than LVRS. However, there is still a chance that you may get pneumonia — an infection that inflames the air sacs of the lung — after BLVR.

Pneumothorax

Pneumothorax occurs when air builds up in the space between the chest wall and lungs. There is a small chance this complication may occur following BLVR, and in most cases is treated by a temporary tube that lets air escape from this space.

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BLVR vs. LVRS

There is one big difference between bronchoscopic lung volume reduction and lung volume reduction surgery: BLVR involves no cutting or stitches while LVRS requires an open incision. This difference can reduce recovery time and lessen the chance of infection.

Lung volume reduction surgery has been commonly available since the early 2000s. The procedure involves surgically removing damaged sections of lung tissue – usually about 20% to 35% of each lung. This “volume reduction” allows the remaining lung tissue to function more efficiently. As a result, patients can breathe more deeply and get more oxygen.

LVRS is major surgery and that brings risks as well as some temporary pain and discomfort. Over the long-term, survival improves but there is a risk of death due to surgery. In one large national study, the overall risk of death in the 3 months after surgery was 3%. The main complication after surgery is an air leak. Other possible complications include infections at the incision site, fever, pneumonia, rapid/irregular heartbeat or heart attack.

After LVRS, most patients breathe more easily and lose that frightening feeling of being unable to take a full deep breath. Patients usually can walk farther and faster than before the surgery. In general, they have a better quality of life.


Dr. Gerard J. Criner portrait

Page medically reviewed by:
Gerard J. Criner, MD, FACP, FACCP
December 10, 2019