TY - JOUR
T1 - Clinical and radiological outcome following pneumothorax after endoscopic lung volume reduction with valves
AU - Gompelmann, D.
AU - Benjamin, N.
AU - Kontogianni, K.
AU - Herth, F. J.F.
AU - Heussel, C. P.
AU - Hoffmann, H.
AU - Eberhardt, R.
N1 - Publisher Copyright:
� 2016 Gompelmann et al.
PY - 2016/12/7
Y1 - 2016/12/7
N2 - Introduction: Valve implantation has evolved as a therapy for patients with advanced emphysema. Although it is a minimally invasive treatment, it is associated with complications, the most common being pneumothorax. Pneumothorax occurs due to the rapid target lobe volume reduction and may be a predictor of clinical benefit despite this complication. Objective: The objective of this study was to conduct an exploratory data analysis of patients who developed a pneumothorax following endoscopic valve therapy for emphysema. Materials and methods: This study performed a retrospective evaluation of pneumothorax management and the impact of pneumothorax on clinical outcomes in 70 patients following valve therapy in 381 consecutive patients. Results: Pneumothorax rate following valve therapy was 18%. Pneumothorax management consisted of chest tube insertion, valve removal, and surgical intervention in 87% (61/70), 44% (31/70), and 19% (13/70) of the patients, respectively. Despite pneumothorax, patients experienced modest but significant improvements in lung function parameters (forced expiratory volume in 1 second: 55�148 mL, residual volume: −390�964 mL, total lung capacity: −348�876; all P<0.05). Persistent lobar atelectasis 3 months after recovering from pneumothorax, which was associated with relevant clinical improvement, was observed in only 21% (15/70) of the patients. Conclusion: Pneumothorax is a frequent severe complication following valve therapy that requires further intervention. Nevertheless, the pneumothorax does not impair the clinical status in the majority of patients. Patients with lobar atelectasis benefit after recovering from pneumothorax in terms of lung function parameters.
AB - Introduction: Valve implantation has evolved as a therapy for patients with advanced emphysema. Although it is a minimally invasive treatment, it is associated with complications, the most common being pneumothorax. Pneumothorax occurs due to the rapid target lobe volume reduction and may be a predictor of clinical benefit despite this complication. Objective: The objective of this study was to conduct an exploratory data analysis of patients who developed a pneumothorax following endoscopic valve therapy for emphysema. Materials and methods: This study performed a retrospective evaluation of pneumothorax management and the impact of pneumothorax on clinical outcomes in 70 patients following valve therapy in 381 consecutive patients. Results: Pneumothorax rate following valve therapy was 18%. Pneumothorax management consisted of chest tube insertion, valve removal, and surgical intervention in 87% (61/70), 44% (31/70), and 19% (13/70) of the patients, respectively. Despite pneumothorax, patients experienced modest but significant improvements in lung function parameters (forced expiratory volume in 1 second: 55�148 mL, residual volume: −390�964 mL, total lung capacity: −348�876; all P<0.05). Persistent lobar atelectasis 3 months after recovering from pneumothorax, which was associated with relevant clinical improvement, was observed in only 21% (15/70) of the patients. Conclusion: Pneumothorax is a frequent severe complication following valve therapy that requires further intervention. Nevertheless, the pneumothorax does not impair the clinical status in the majority of patients. Patients with lobar atelectasis benefit after recovering from pneumothorax in terms of lung function parameters.
KW - COPD
KW - Emphysema
KW - Endoscopic valve therapy
KW - Pneumothorax
UR - http://www.scopus.com/inward/record.url?scp=85007415258&partnerID=8YFLogxK
U2 - 10.2147/COPD.S117890
DO - 10.2147/COPD.S117890
M3 - Article
C2 - 27994448
AN - SCOPUS:85007415258
SN - 1176-9106
VL - 11
SP - 3093
EP - 3099
JO - International Journal of COPD
JF - International Journal of COPD
IS - 1
ER -