Management / Treatment of Emphysema
The medical management of COPD and Emphysema is largely the same, but the following are specific to emphysema:
- Bullectomy (removal of emphysematous bullae)
- Lung volume reduction surgery
- Lung transplantation
Bullectomy and Lung Volume Reduction Surgery
This is used in persons with advanced emphysema.
Breathless people with a single large bulla, and an FEV1 of less than 50% should be considered for bullectomy.
Parts of affected (i.e. very expanded) lung are removed to reduce volume and improve efficiency of the remaining lung in persons in whom maximal medical therapy is not effective, as long as strict criteria are met.
Lung Transplantation
This should be considered in those with advanced emphysema, whose activities of daily living and quality of life are greatly restricted despite maximal medical therapy.
One source states that a very small group of persons are eligible for this and is mainly young people with severe disease suffering from Alpha1 Antitrypsin deficiency. Transplantation is usually of one lung.
