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Bronchoscopic valve placement for the treatment of persistent air leaks.

Abstract Persistent air leaks (PALs) are associated with increased morbidity, prolonged hospital stay, and increased treatment costs. Endobronchial 1-way valves have been recently used as a potential less invasive treatment option. We sought to investigate the effects of valve therapy in treating this condition. The patients with evidence of continuous air leak flow whose chest tubes remained in place for more than 7 days were treated with bronchoscopic closure using 1-way valves. The source of the air leak was identified by the Chartis system.A total of 11 patients (1 woman, 10 men; mean age, 68 years) who underwent valve placement were eligible to be enrolled from January 2015 through January 2017. Six patients had postoperative PAL, and 5 had a secondary spontaneous pneumothorax. The number of used valves varied from 1 to 3 (median 1). The resolution of the leak was complete in 8 patients (72.7%), whose mean duration of air leak before and after valve deployment was 58.5 and 4.5 days, respectively. There were no complications related to the valve deployment.Bronchoscopic placement of 1-way valves is a safe procedure that could help manage patients with prolonged PALs. A prospective randomized trial with cost-efficiency analysis is necessary to better define the role of this bronchoscopic intervention and demonstrate its effect on air leak duration.
PMID
Related Publications

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Authors

Mayor MeshTerms

Prostheses and Implants

Keywords
Journal Title medicine
Publication Year Start




PMID- 29595651
OWN - NLM
STAT- MEDLINE
DCOM- 20180411
LR  - 20180411
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 13
DP  - 2018 Mar
TI  - Bronchoscopic valve placement for the treatment of persistent air leaks.
PG  - e0183
LID - 10.1097/MD.0000000000010183 [doi]
AB  - Persistent air leaks (PALs) are associated with increased morbidity, prolonged
      hospital stay, and increased treatment costs. Endobronchial 1-way valves have
      been recently used as a potential less invasive treatment option. We sought to
      investigate the effects of valve therapy in treating this condition. The patients
      with evidence of continuous air leak flow whose chest tubes remained in place for
      more than 7 days were treated with bronchoscopic closure using 1-way valves. The 
      source of the air leak was identified by the Chartis system.A total of 11
      patients (1 woman, 10 men; mean age, 68 years) who underwent valve placement were
      eligible to be enrolled from January 2015 through January 2017. Six patients had 
      postoperative PAL, and 5 had a secondary spontaneous pneumothorax. The number of 
      used valves varied from 1 to 3 (median 1). The resolution of the leak was
      complete in 8 patients (72.7%), whose mean duration of air leak before and after 
      valve deployment was 58.5 and 4.5 days, respectively. There were no complications
      related to the valve deployment.Bronchoscopic placement of 1-way valves is a safe
      procedure that could help manage patients with prolonged PALs. A prospective
      randomized trial with cost-efficiency analysis is necessary to better define the 
      role of this bronchoscopic intervention and demonstrate its effect on air leak
      duration.
FAU - Huang, Xiaojie
AU  - Huang X
AD  - Department of Respiratory Medicine, Second Affiliated Hospital, Zhejiang
      University School of Medicine, Hangzhou, China.
FAU - Ding, Liren
AU  - Ding L
FAU - Xu, Hao
AU  - Xu H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Bronchoscopy/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pleural Diseases/*surgery
MH  - Prospective Studies
MH  - *Prostheses and Implants
MH  - Prosthesis Implantation/adverse effects/*methods
EDAT- 2018/03/30 06:00
MHDA- 2018/04/12 06:00
CRDT- 2018/03/30 06:00
PHST- 2018/03/30 06:00 [entrez]
PHST- 2018/03/30 06:00 [pubmed]
PHST- 2018/04/12 06:00 [medline]
AID - 10.1097/MD.0000000000010183 [doi]
AID - 00005792-201803300-00024 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Mar;97(13):e0183. doi: 10.1097/MD.0000000000010183.