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Recommendations for the use of endoscopic lung volume reduction in South Africa: Role in the treatment of emphysema

Coenraad F N Koegelenberg, Johan Theron, Keertan Dheda, Willie Bruwer, Brian Allwood, Morné Vorster, Florian von Groote-Bidlingmaier, Dirk-Jan Slebos, Pallav Shah, Felix Herth

Abstract


Emphysema is a very common cause of morbidity and mortality in South Africa (SA). Therapeutic options in severe emphysema are limited. Endoscopic lung volume reduction (ELVR) is increasingly being used internationally for the treatment of advanced emphysema in a subset of patients with advanced disease, aiming to obtain the same functional advantages as surgical lung volume reduction while reducing risks and costs. In addition to endobronchial valves, ELVR using endobronchial coils is now available in SA. The high cost of these interventions underscores the need for careful patient selection to best identify those who may or may not benefit from ELVR-related procedures. The Assembly on Interventional Pulmonology of the South African Thoracic Society appointed a committee comprising both local and international experts to extensively review all relevant evidence and provide advice on the use of ELVR in SA based on published evidence, expert opinion and local access to the various devices.

Authors' affiliations

Coenraad F N Koegelenberg, Pulmonology and Critical Care, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa

Johan Theron, Panorama Mediclinic, Cape Town, South Africa

Keertan Dheda, Lung Infection and Immunity Unit and Division of Pulmonology, Department of Medicine and UCT Lung Institute, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

Willie Bruwer, Windhoek Mediclinic, Namibia

Brian Allwood, Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa

Morné Vorster, Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa

Florian von Groote-Bidlingmaier, Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, Cape Town, South Africa

Dirk-Jan Slebos, Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Netherlands

Pallav Shah, Royal Brompton Hospital, London, UK

Felix Herth, Pulmonology and Critical Care Medicine, Thoraxklinik, University Hospital Heidelberg, Heidelberg, Germany

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Keywords

Emphysema; Endoscopic lung volume reduction; South Africa

Cite this article

South African Medical Journal 2015;105(10):810-815. DOI:10.7196/SAMJnew.8147

Article History

Date submitted: 2015-09-19
Date published: 2015-09-19

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