TY - JOUR
T1 - Unidirectional endobronchial valves for management of persistent air-leaks
T2 - Results of a multicenter study
AU - Fiorelli, Alfonso
AU - D'Andrilli, Antonio
AU - Cascone, Roberto
AU - Occhiati, Luisa
AU - Anile, Marco
AU - Diso, Daniele
AU - Cassiano, Francesco
AU - Poggi, Camilla
AU - Ibrahim, Mohsen
AU - Cusumano, Giacomo
AU - Terminella, Alberto
AU - Failla, Giuseppe
AU - Sala, Alba La
AU - Bezzi, Michela
AU - Innocenti, Margherita
AU - Torricelli, Elena
AU - Venuta, Federico
AU - Rendina, Erino Angelo
AU - Vicidomini, Giovanni
AU - Santini, Mario
AU - Andreetti, Claudio
N1 - Publisher Copyright:
© Journal of Thoracic Disease.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background: To evaluate the efficacy of Endo-Bronchial Valves in the management of persistent air-leaks (PALs) and the procedural cost. Methods: It was a retrospective multicenter study including consecutive patients with PALs for alveolar pleural fistula (APF) undergoing valve treatment. We assessed the efficacy and the cost of the procedure. Results: Seventy-four patients with persistent air leaks due to various etiologies were included in the analysis. In all cases the air leaks were severe and refractory to standard treatments. Sixty-seven (91%) patients underwent valve treatment obtaining a complete resolution of air-leaks in 59 (88%) patients; a reduction of air-leaks in 6 (9%); and no benefits in 2 (3%). The comparison of data before and after valve treatment showed a significant reduction of air-leak duration (16.2±8.8 versus 5.0±1.7 days; P<0.0001); chest tube removal (16.2±8.8 versus 7.3±2.7 days; P<0.0001); and length of hospital stay (LOS) (16.2±8.8 versus 9.7±2.8 days; P=0.004). Seven patients not undergoing valve treatment underwent pneumo-peritoneum with pleurodesis (n=6) or only pleurodesis (n=1). In only 1 (14%) patient, the chest drainage was removed 23 days later while the remaining 6 (86%) were discharged with a domiciliary chest drainage removed after 157±41 days. No significant difference was found in health cost before and after endobronchial valve (EBV) implant (P=0.3). Conclusions: Valve treatment for persistent air leaks is an effective procedure. The reduction of hospitalization costs related to early resolution of air-leaks could overcome the procedural cost.
AB - Background: To evaluate the efficacy of Endo-Bronchial Valves in the management of persistent air-leaks (PALs) and the procedural cost. Methods: It was a retrospective multicenter study including consecutive patients with PALs for alveolar pleural fistula (APF) undergoing valve treatment. We assessed the efficacy and the cost of the procedure. Results: Seventy-four patients with persistent air leaks due to various etiologies were included in the analysis. In all cases the air leaks were severe and refractory to standard treatments. Sixty-seven (91%) patients underwent valve treatment obtaining a complete resolution of air-leaks in 59 (88%) patients; a reduction of air-leaks in 6 (9%); and no benefits in 2 (3%). The comparison of data before and after valve treatment showed a significant reduction of air-leak duration (16.2±8.8 versus 5.0±1.7 days; P<0.0001); chest tube removal (16.2±8.8 versus 7.3±2.7 days; P<0.0001); and length of hospital stay (LOS) (16.2±8.8 versus 9.7±2.8 days; P=0.004). Seven patients not undergoing valve treatment underwent pneumo-peritoneum with pleurodesis (n=6) or only pleurodesis (n=1). In only 1 (14%) patient, the chest drainage was removed 23 days later while the remaining 6 (86%) were discharged with a domiciliary chest drainage removed after 157±41 days. No significant difference was found in health cost before and after endobronchial valve (EBV) implant (P=0.3). Conclusions: Valve treatment for persistent air leaks is an effective procedure. The reduction of hospitalization costs related to early resolution of air-leaks could overcome the procedural cost.
KW - Alveolar-pleural fistula
KW - Bronchoscopy
KW - Persistent air-leak (PAL)
KW - Zephyr endobronchial valves (Zephyr EBV)
UR - http://www.scopus.com/inward/record.url?scp=85057627633&partnerID=8YFLogxK
U2 - 10.21037/jtd.2018.10.61
DO - 10.21037/jtd.2018.10.61
M3 - Article
C2 - 30622787
AN - SCOPUS:85057627633
SN - 2072-1439
VL - 10
SP - 6158
EP - 6167
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
IS - 11
ER -