Sequential Bilateral Bronchoscopic Lung Volume Reduction With One-Way Valves for Heterogeneous Emphysema
| Autor: | Erino A. Rendina, Mario Santini, Federico Venuta, Alfonso Fiorelli, Daniele Diso, Camilla Poggi, Giuseppe Failla, Mario Polverino, Antonio D'Andrilli, Marco Anile |
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| Přispěvatelé: | Fiorelli, Alfonso, D'Andrilli, Antonio, Anile, Marco, Diso, Daniele, Poggi, Camilla, Polverino, Mario, Failla, Giuseppe, Venuta, Federico, Rendina, Erino Angelo, Santini, Mario |
| Rok vydání: | 2016 |
| Předmět: |
Male
Vital capacity LVRS lung volume reduction surgery 030204 cardiovascular system & hematology Lung volume reduction surgery Severity of Illness Index Bronchoscopic lung volume reduction BLVR bronchoscopic lung volume reduction 0302 clinical medicine Forced Expiratory Volume Surveys and Questionnaires Respiratory function Respiratory system Pneumonectomy medicine.diagnostic_test Middle Aged Treatment Outcome Pulmonary Emphysema RV residual volume Anesthesia Female Cardiology and Cardiovascular Medicine Adult Pulmonary and Respiratory Medicine medicine.medical_specialty High-resolution computed tomography forced expiratory volume in 1 second FEV1 forced expiratory volume in 1 second Bronchi 03 medical and health sciences FEV1/FVC ratio Bronchoscopy medicine Humans EBV endobronchial valve Aged Retrospective Studies SGRQ St. George's Respiratory Questionnaire business.industry Endobronchial valve FEV 6MWT 6-minute walk test FVC forced vital capacity HRCT high-resolution computed tomography Surgery 030228 respiratory system business |
| Zdroj: | The Annals of Thoracic Surgery. 102:287-294 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2016.02.018 |
| Popis: | Background. Clinical benefits of bronchoscopic lung volume reduction with one-way endobronchial valves have been reported for heterogeneous emphysema after unilateral treatment. We assessed the potential role of contralateral treatment to prolong the benefits obtained with the first procedure.Methods. This was a retrospective multicenter study including consecutive patients with heterogeneous emphysema undergoing bronchoscopic valves deployment during the last 4 years. Patients were split into two groups depending on the procedure (unilateral versus bilateral). The intergroup differences were evaluated to assess the viability, effectiveness, and safety of the bilateral procedure.Results. Forty-nine patients were enrolled. Of these, 14 (28%) had a sequential bilateral procedure mainly due to loss of the clinical benefits obtained with the first treatment. A significant improvement of forced expiratory volume in 1 second (p < 0.05), forced vital capacity (p < 0.05), residual volume (p < 0.05), 6-minute walking test (p < 0.05), and St. George respiratory questionnaire (p < 0.02) was achieved after the second procedure. These results were maintained during follow-up. There was no significant difference regarding the changes of forced expiratory volume in 1 second (p = 0.4), forced vital capacity (p = 0.08), residual volume (p = 0.9), 6-minute walking test (p = 0.3), and St. George respiratory questionnaire (p = 0.1) between the bilateral and unilateral groups.Conclusions. A sequential bilateral approach seems to be a valid strategy to improve respiratory function in patients with bilateral heterogeneous emphysema who have lost the benefits obtained with the first procedure. (C) 2016 by The Society of Thoracic Surgeons |
| Databáze: | OpenAIRE |
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