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Use of Resector Balloon Desobstruction in Patients With Severe Chronic Obstructive Pulmonary Disease: A Pilot Feasibility Study on a Novel Desobstruction Technique

Background:Inflammation of the small airways (bronchiolitis) contributes to airflow limitation by narrowing and obliterating the airway lumen in patients with chronic obstructive pulmonary disease (COPD). Although currently available treatments provide satisfactory disease control in most patients, a significant number of patients do not respond. This study presents the outcomes of Karakoca resector balloon desobstruction in patients with severe COPD who did not respond to medical treatment. Methods:Ten COPD patients classified as stage IV by the Global Initiative for Obstructive Lung Disease (GOLD) and unsuccessfully treated with high-dose bronchodilators and corticosteroids, oral corticosteroids, oxygen, and NIMV therapy underwent therapeutic bronchoscopy, including balloon desobstruction for segmental and subsegmental bronchi. Exercise capacity and SpO2 levels were measured and lung function tests and bronchoscopic biopsies performed before and after the intervention. Results:After Karakoca resector balloon desobstruction, improvements were noted in the effort capacity, SpO2 and forced expiratory volume in 1 second levels of all patients. None of the patients developed preoperative complications or complication or exacerbation within the postoperative 1 to 3 months of follow-up. Conclusion:Satisfactory results were achieved in all patients, warranting study of Karakoca resector balloon desobstruction in larger patient cohorts.