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  • Title: [New therapeutic possibilities in pulmonary emphysema. Conservative therapy--surgical lung volume reduction--lung transplantation].
    Author: Konietzko N.
    Journal: Fortschr Med; 1998 May 20; 116(14):20-2, 24, 26. PubMed ID: 9648389.
    Abstract:
    The spectrum of therapeutic possibilities in pulmonary emphysema has recently been expanded by surgical lung volume reduction. Improvements in surgical technique have now lowered the mortality rate of the procedure to less than 5%, thus providing a chance of prolonging survival and improving the quality of life of severely ill patients in need of oxygen. To date, experience has been gained with this procedure in several thousands of patients in the U.S.A. and Europe, some groups of patients have now been followed up for about three years. The procedure is not recommended for use in patients with genetically determined alpha 1-antitrypsin deficiency. Surgical bullectomy is practiced when individual bullae affect more than 50% of a lung. In special cases, the possibility of lung transplantation should also be considered. In addition to the invasive approaches, survival, but in particular quality of life, can also be improved by conservative procedures. These include medical anti-obstructive treatment, the early use of antibiotics in the case of infections, but also physiotherapeutic measures such as pursed-lip breathing and exercises to strengthen diaphragma. Palliative measures in advanced stages are long-term oxygen therapy and in special cases non-invasive self-ventilation.
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