A retrospective review comparing the treatment outcomes of emergency lung resection for massive haemoptysis with and without preoperative bronchial artery embolization

Alexander, Gerard R.

doi:10.1093/ejcts/ezt336

Cited by 34 publications

(30 citation statements)

References 11 publications

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“…In the current literature there is no consensus about the timing of the surgical resection in cases of lung aspergilloma. But since the hemorrhage comes from the bronchial artery system in majority of patients, embolization may control the hemoptysis in only 75 % of cases, with a recurrence rate up to 75 % [ 8 – 10 ]. We were unable to study the results of this method on our patients since the majority of these cases were treated in the department of pulmonology.…”

Section: Discussionmentioning

confidence: 99%

Lung resection in pulmonary aspergilloma: experience of a Moroccan center

et al. 2015

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BackgroundThis study was conducted to determine the efficacy of surgery in the treatment of complex aspergilloma comparatively with simple aspergilloma.MethodsFrom January 2006 to December 2014, 115 cases of pulmonary aspergilloma were admitted in our department. One operation on one side was counted as one case and the patients were divided into two groups. In group A: 61 cases of complex aspergilloma. In group B: 50 patients underwent 54 cases of lung resection for simple aspergilloma. People who underwent arteriography and embolization were excluded. Surgical treatment was indicated when 1) recurrent aspergilloma-related hemoptysis, 2) definite simple or complex aspergilloma and 3) a simultaneous bilateral aspergilloma.ResultsPeople with complex aspergilloma were big smokers with lower BMI, and had reduced lung function parameters. The main symptoms were repeated hemoptysis, chronic cough, abundant purulent expectoration and respiratory infections. Lobectomy was the most performed indication. In group B, number of wedge resections was larger than group A with statistical significant difference (p = 0.001). In the post-operative course morbidity was higher in group A (16 %) vs (9 %) in group B with statistical difference (p = 0.026). The median follow-up was 30 months (range 19–52 months).The median duration of chest tube drainage was 4 days. The duration of chest tube drainage was longer in the group A (4.7 ± 1.4 versus 2.9 ± 1.3; p = 0.005). The prolonged postoperative air leakage occurred more frequently in group A (14.75 %; versus 1.8 % p = 0.015). In group A, 3 cases and 2 in group B underwent a secondary operation for post operative hemothorax. Bronchopleural fistula occurred exclusively in group A (n = 4).ConclusionsThe surgical resection should be used in a multidisciplinary approach. Preoperative Interventional therapies could optimize the conditions for the operation. Total surgical resection must be the treatment of choice of localized causative lesions.

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Section: Discussionmentioning

confidence: 99%

Lung resection in pulmonary aspergilloma: experience of a Moroccan center

et al. 2015

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“…Immediate positive full effect of REEBA in the form of a complete stop bleeding was observed in 78 (89.8±1.2 %, p≤0.05) patients. Other authors perceived similar efficiency of endovascular hemostasis [22,23]. Late relapses of LB and blood coughing was observed in 17 (20±2.1 %, p≤0.05) of patients [24].…”

Section: Resultsmentioning

confidence: 56%

Possibilities of Using Miniinvasive Catheter Technologies in the Treatment of Lung Bleeding

Ponomarova¹

2019

EUREKA: Health Sciences

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Aim – improve the results of the treatment of patients with pulmonary bleeding through widespread use of endovascular surgery methods for hemostasis. Materials and methods. Method of endovascular embolization of bronchial arteries is widely used in our clinic SI «Zaycev V. T. Institute of General and Emergency surgery of NAMS of Ukraine» not only as independent surgery in patients with LB, but also as way of preparation of patients with lung bleeding for planned thorax surgery. The most of the often spread nosological forms complicated by bleeding in our research were polycystic lung disease, chronic obstructive pulmonary disease, bronchiectasis disease, community-acquired pneumonia. Indications to the сatheter embolization procedure of bronchial arteries are the following: conservative treatment failure, hemoptysis in patients with bilateral inflammatory processes who was not prescribed surgical treatment for a range of reasons, absence of gross structural changes, lung resection, mainly in patients with oncologic lung injury, at massive and life-threatening profuse bleedings as a mean of temporary or constant hemostasis. Discussed treatment method is applied only in bleeding or within a 6 – 12 hour after its treatment. Successful result in embolization can be obtained in 79–99 %. Results. As a result of complete physical examination of patients with LB, it has been established that lung hemorrhage was the result of obstructive bronchitis in 14 patients (42 %), there was chronic obstructive pulmonary disease in 7 (21 %) patients and bronchiectasis was diagnosed in 6 (18 %) patients. In 2 (6 %) patients pulmonary hemorrhage was caused by community-acquired pneumonia. Central lung cancer was detected in 4 (12 %) patients. Conclusion. Therefore bronchial artery angiography gives high efficiency in solving the problem of hemostasis in oncological and nonspecific lung diseases, for determination of localization and source of bleeding. Endovascular occlusion of bronchial arteries in pulmonary hemorrhage permits: – to elaborate diagnosis because of the presence of specific angiographic signs of malignant tumour; – to perform effective endovascular hemostasis; – to gain time for stabilization the patient with the aim of planned surgical treatment.

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“…Bronchial artery embolization (BAE) was first suggested in 1974 and it has become the most effective method of controlling massive hemoptysis currently through 40 years of developing and improving, which is featured by being safe, minimally invasive and highly efficient and its success rate of hemostasis is more than 90% (8). In our cases embolism was performed in 25 cases, of these hemoptysis in 21 cases was stopped immediately and the effective rate was 84.00%, and it basically agrees with other reports.…”

Section: Discussionmentioning

confidence: 99%

Intervention treatment on massive hemoptysis of pulmonary aspergilloma

Liu

Gao

et al. 2017

Experimental and Therapeutic Medicine

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Retrospective analysis was carried out on intervention treatment and the effects of massive hemoptysis of pulmonary aspergilloma. Twenty-five cases diagnosed as massive hemoptysis of pulmonary aspergilloma were performed with imaging of bronchial arteries and other related blood vessels in order to assess blood vessel type and the number involved in the disease and perform embolotherapy on the offending artery. There were 68 bleeding arteries in 25 cases, of which there were 36 bronchial arteries (52.94%), 15 intercostal arteries (22.06%), 9 internal thoracic arteries (16.17%), 5 inferior phrenic arteries (7.35%), and 3 pulmonary arterial branches (4.41%) and all of them were in embolism condition. For 25 cases, 21 bleeding cases were stopped immediately (84.00%), 3 bleeding cases were stopped after the 2nd embolism, and 1 case had a small amount of hemoptysis after surgery discontinuously, which was stopped after corresponding treatment with no severe complications. Ten cases used polyvinyl alcohol (PVA) particulate embolization solely, 12 cases used PVA with spring coil and 3 cases used PVA, spring coil and N-butyl cyanoacrylate (NBCA) glue. In conclusion, patients who suffer from massive hemoptysis of pulmonary aspergilloma and whose medical treatments are not effective and who are not willing to receive surgical removal, intervention treatment is an effective method. PVA, spring coil and NBCA glue can be effectively used in hemoptysis embolism and pulmonary artery embolism can be considered when systemic embolism is not effective.

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A retrospective review comparing the treatment outcomes of emergency lung resection for massive haemoptysis with and without preoperative bronchial artery embolization

Cited by 34 publications

References 11 publications

Lung resection in pulmonary aspergilloma: experience of a Moroccan center

Lung resection in pulmonary aspergilloma: experience of a Moroccan center

Possibilities of Using Miniinvasive Catheter Technologies in the Treatment of Lung Bleeding

Intervention treatment on massive hemoptysis of pulmonary aspergilloma

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