@article{JOVS17361,
author = {Alfonso Fiorelli and Carlo Santoriello and Alberto De Felice and Francesco Ferrigno and Annalisa Carlucci and Emanuele De Ruberto and Rossella Mastromarino and Lisa Occhiati and Gaetana Messina and Elena Santoriello and Giovanni Vicidomini and Mario Polverino and Mario Santini},
title = {Bronchoscopic lung volume reduction with endobronchial valves for heterogeneous emphysema: long-term results},
journal = {Journal of Visualized Surgery},
volume = {3},
number = {11},
year = {2017},
keywords = {},
abstract = {Background: Bronchoscopic lung volume reduction (BLVR) with implant of one-way endobronchial valves (EBV) is a feasible treatment for management of heterogeneous emphysema (HE) with clinical benefits in the early follow-up. We aimed to evaluate the long-terms results and safety of this procedure in a consecutive series of patients with HE.
Methods: It was a retrospective single center study including all consecutive patients with HE undergoing EBV treatment and completing at least 5 years of long-term follow-up. Patients were splitted into Collapse and No-Collapse Group if a lobar collapse or not were obtained after valves implant. The difference of functional data and quality of life (QoL) before and after the procedure (measured at 3, 6, 9, 12 months from the valve implantation, and then annually up to a maximum of 5 years) were statistically evaluated to show the long-term benefits of the procedure (primary endpoint). Yet, morbidity, mortality and survival rates were also recorded to show the safe of the treatment (secondary endpoint).
Results: Thirty-three patients were included in the study. Of these, three patients underwent a bilateral treatment. Collapse Group patients (n=27) presented a significant improvement in FEV1% (+17%; P=0.001); in FVC% (+18%; P=0.002); in RV% (−39%; P=0.003); in 6MWT (P=0.001) and in SGRQ (P=0.001) in the early 12 months of follow-up and no significant decline was seen later. Conversely, No-Collapse Group (n=9) did not have significant benefits. No major complications and death related to the procedure were observed. The 1-,2-,3-,4- and 5-year survival rates were 100%, 90%, 78%, 71% and 71%, respectively. Collapse Group had a better survival than No-Collapse Group (45 vs. 24 months; P=0.001).
Conclusions: Our study confirmed that the lobar collapse is the key success of EBV treatment and the early improvements of respiratory function could be maintained up to five years from the valves implant.},
issn = {2221-2965}, url = {https://jovs.amegroups.org/article/view/17361}
}