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

Sequential bilateral bronchoscopic lung volume reduction with one-way valves for heterogeneous emphysema / Fiorelli, Alfonso; D'Andrilli, ANTONIO LUCIO; Anile, Marco; Diso, Daniele; Poggi, Camilla; Polverino, Mario; Failla, Giuseppe; Venuta, Federico; Rendina, Erino Angelo; Santini, Mario. - In: ANNALS OF THORACIC SURGERY. - ISSN 0003-4975. - 102:1(2016), pp. 287-294. [10.1016/j.athoracsur.2016.02.018]

Sequential bilateral bronchoscopic lung volume reduction with one-way valves for heterogeneous emphysema

D'ANDRILLI, ANTONIO LUCIO;ANILE, MARCO;DISO, DANIELE;POGGI, CAMILLA;VENUTA, Federico;RENDINA, Erino Angelo;
2016

Abstract

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
2016
6MWT 6-minute walk test; BLVR bronchoscopic lung volume reduction; EBV endobronchial valve; FEV1 forced expiratory volume in 1 second; FVC forced vital capacity; HRCT high-resolution computed tomography; LVRS lung volume reduction surgery; RV residual volume; SGRQ St. George's Respiratory Questionnaire; Cardiology and Cardiovascular Medicine; Surgery; Pulmonary and Respiratory Medicine
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Sequential bilateral bronchoscopic lung volume reduction with one-way valves for heterogeneous emphysema / Fiorelli, Alfonso; D'Andrilli, ANTONIO LUCIO; Anile, Marco; Diso, Daniele; Poggi, Camilla; Polverino, Mario; Failla, Giuseppe; Venuta, Federico; Rendina, Erino Angelo; Santini, Mario. - In: ANNALS OF THORACIC SURGERY. - ISSN 0003-4975. - 102:1(2016), pp. 287-294. [10.1016/j.athoracsur.2016.02.018]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/935967
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