Outcome of Surgical and Endoscopic Lung Volume Reduction with Valves in Patients with Severe Lung Emphysema: Preliminary Results from the National Lung Emphysema Registry (LE-R) in Germany

Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Lung volume reduction surgery (LVRS) has been suggested as an efficacious treatment strategy with a good safety profile in patients with severe emphysema. However, current techniques such as the endoscopic lung volume reduction with endobronchial valves (ELVR-V) have gained attention and seem also to produce favorable outcomes. Using data from the lung emphysema registry (LE-R) our endeavor is to describe treatment outcomes of the applied strategies over time. Methods: The LE-R is a national multicenter open label prospective registry collecting data exclusively on patients with severe lung emphysema undergoing LVRS or ELVR-V. Local emphysema boards made treatment decision. The patients were followed up after 3-and 6-months, and the lung function as well as the clinical status and the quality of life, measured with the 6-MWT and mMRC, were documented. All patients underwent pulmonary rehabilitation before undergoing the procedure. Results: Since September 2017, 358 cases were treated at 14 specialized centers in Germany. Mean age was 65.0 y (SD 7.7) and there was a male predominance (63.6%). Table 1 displays differences of lung function and quality of life between the groups at baseline, 3- and 6-mo follow up. Conclusions: Overall, our findings highlight that LVR by surgery or valves lead to significant improvements in multiple efficacy outcomes at a long term follow up. Future randomized studies are warranted to substantiate our results due to the observational nature of our study