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Endobronchial valve for treatment of persistent air leak complicating spontaneous pneumothorax.
Yu, W C; Yu, E Lm; Kwok, H C; She, H L; Kwong, K K; Chan, Y H; Tsang, Y L; Yeung, Y C.
Afiliación
  • Yu WC; Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Yu EL; Clinical Research Centre, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Kwok HC; Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong.
  • She HL; Department of Radiology, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Kwong KK; Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Chan YH; Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Tsang YL; Central Endoscopy Unit, Princess Margaret Hospital, Laichikok, Hong Kong.
  • Yeung YC; Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong.
Hong Kong Med J ; 24(2): 158-165, 2018 04.
Article en En | MEDLINE | ID: mdl-29622759
INTRODUCTION: Endobronchial one-way valves have been proposed as treatment for persistent air leak complicating spontaneous pneumothorax in which surgical intervention is not feasible. However, published data on efficacy, safety, and factors associated with success are scanty. METHODS: This is a retrospective study of 37 patients at a general hospital from 2008 to 2016. The impact of endobronchial valve implantation on the time to air-leak cessation after bronchoscopy was evaluated. RESULTS: The median patient age was 71 years. The majority of patients were males (92%), were ever-smokers (83%), had at least one co-morbidity (97%), and had secondary spontaneous pneumothorax (89%). Nineteen patients (51%) had a mean of 2.6 endobronchial valves implanted (range, 1-6). The air leak ceased within 72 hours for only eight patients (22% of the complete cohort), with immediate air-leak cessation after completion of endobronchial valve implantation. All six successful cases that had computed tomographic data of the thorax were shown to have bilateral intact interlobar fissures. The median (interquartile range) Charlson co-morbidity index was 1 (0.25-1) and 2 (1-3) for the success group and failure group, respectively (P=0.029). All patients in the no-endobronchial valve group survived, whereas three patients in the endobronchial valve group died within 30 days of endobronchial valve implantation. CONCLUSION: Only a small proportion of cases of endobronchial valve implantation for air leak complicating pneumothorax had unequivocal success. Intact bilateral interlobar fissures appear to be a necessary, though not sufficient, condition for success. Patients with fewer medical co-morbidities and immediate air-leak cessation after endobronchial valve implantation have a higher likelihood of success.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumotórax / Prótesis e Implantes Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Hong Kong Med J Asunto de la revista: MEDICINA Año: 2018 Tipo del documento: Article País de afiliación: Hong Kong Pais de publicación: China
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumotórax / Prótesis e Implantes Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Hong Kong Med J Asunto de la revista: MEDICINA Año: 2018 Tipo del documento: Article País de afiliación: Hong Kong Pais de publicación: China