interventional pulmonology

Emphysema is a parenchymal tissue destruction resulting from chronic inflammatory response to inhaled cigarette smoke and other noxious agents that disrupt normal repair mechanisms and results in small airway fibrosis. These pathological changes lead to air trapping and progressive air flow limitation. Surgical lung volume reduction (LVRS) can be performed for patients with advanced emphysema. However, serious post-surgical complications, including cardiac ischaemia, arrhythmia and pulmonary embolus, were observed more frequently. Lung transplantation also improves pulmonary function, symptoms, functional capacity, and quality of life in patients with advanced emphysema, but Chronic rejection remains a major unresolved problem among patients who undergo lung transplantation, and is associated with a 50% 5 year mortality. Therefore, minimally invasive techniques had been proposed to reduce lung volume in those patients without undergoing open thoracotomy. Different endoscopic LVR (ELVR) systems are undergoing evaluation to avoid surgical LVRS without the concomitant surgical morbidity and mortality. For example, endobronchial valve and endobronchial coils but the cost of these methods is high. Silver nitrate is a cauterizing agent if applied to the mucosa it will lead to coagulation of cellular protein with eschar formation, degenerative changes in the musculature and the bronchial wall and surrounding parenchyma showed marked edema so, if silver nitrate is applied to bronchial mucosa, it will lead to bronchial mucosa swelling and ulceration with subsequent complete stenosis of airway.The aim of work is to assess the efficacy and safety of use of Silver Nitrate in bronchoscopic lung.