Complications of Endobronchial Valve Placement for Bronchoscopic Lung Volume Reduction

Low, See Wei; Swanson, Karen L.; Lee, Justin Z.; Tan, Min-Choon; Cartin‐Ceba, Rodrigo; Sakata, Keiko; Maldonado, Fabien

doi:10.1097/lbr.0000000000000859

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…Recently published data from the CELEB trial showed an incidence of pneumothorax as high as 30.4% [ 15 ]. Another study found that 43% of cases were complicated by pneumothorax needing additional treatment for persistent air leak besides chest drain [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of reoperation after lung volume reduction surgery

Lund,

Soldath,

Nodin

et al. 2023

Surg Endosc

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Objectives Lung volume reduction surgery (LVRS) has proven an effective treatment for emphysema, by decreasing hyperinflation and improving lung function, activity level and reducing dyspnoea. However, postoperative air leak is an important complication, often leading to reoperation. Our aim was to analyse reoperations after LVRS and identify potential predictors. Methods Consecutive single-centre unilateral VATS LVRS performed from 2017 to 2022 were included. Typically, 3–5 minor resections were made using vascular magazines without buttressing. Data were obtained from an institutional database and analysed. Multivariable logistic regression was used to identify predictors of reoperation. Number and location of injuries were registered. Results In total, 191 patients were included, 25 were reoperated (13%). In 21 patients, the indication for reoperation was substantial air leak, 3 patients bleeding and 1 patient empyema. Length of stay (LOS) was 21 (11–33) vs. 5 days (3–11), respectively. Only 3 injuries were in the stapler line, 13 within < 2cm and 15 injuries were in another site. Multivariable logistic regression analysis showed that decreasing DLCO increased risk of reoperation, OR 1.1 (1.03, 1.18, P = 0.005). Resections in only one lobe, compared to resections in multiple lobes, were also a risk factor OR 3.10 (1.17, 9.32, P = 0.03). Patients undergoing reoperation had significantly increased 30-day mortality, OR 5.52 (1.03, 26.69, P = 0.02). Conclusions Our incidence of reoperation after LVRS was 13% leading to prolonged LOS and increased 30-day mortality. Low DLCO and resections in a single lobe were significant predictors of reoperation. The air leak was usually not localized in the stapler line. Graphical abstract Key question: What characterizes reoperations after lung volume reduction surgeries? Key findings: Lung injuries were predominantly located away from the original surgical site. Take home message: Lung injuries remote from the stapler line is frequent during reoperation after lung volume reduction surgery. Location of lung injuries found during reoperation after lung volume reduction surgery

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Section: Discussionmentioning

confidence: 99%

Predictors of reoperation after lung volume reduction surgery

Lund,

Soldath,

Nodin

et al. 2023

Surg Endosc

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“…Upon manual review, 135 articles with unclear queries 32–164 and 120 with incomplete queries 165–284 were excluded. Ultimately, 60 executable queries were found 5,10,285–342 . A comprehensive flowchart of this selection process is depicted in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

Assessing the Reproducibility of Research Based on the Food and Drug Administration Manufacturer and User Facility Device Experience Data

Li,

Feng,

Gong

et al. 2024

J Patient Saf

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Objective This article aims to assess the reproducibility of Manufacturer and User Facility Device Experience (MAUDE) data-driven studies by analyzing the data queries used in their research processes. Methods Studies using MAUDE data were sourced from PubMed by searching for “MAUDE” or “Manufacturer and User Facility Device Experience” in titles or abstracts. We manually chose articles with executable queries. The reproducibility of each query was assessed by replicating it in the MAUDE Application Programming Interface. The reproducibility of a query is determined by a reproducibility coefficient that ranges from 0.95 to 1.05. This coefficient is calculated by comparing the number of medical device reports (MDRs) returned by the reproduced queries to the number of reported MDRs in the original studies. We also computed the reproducibility ratio, which is the fraction of reproducible queries in subgroups divided by the query complexity, the device category, and the presence of a data processing flow. Results As of August 8, 2022, we identified 523 articles from which 336 contained queries, and 60 of these were executable. Among these, 14 queries were reproducible. Queries using a single field like product code, product class, or brand name showed higher reproducibility (50%, 33.3%, 31.3%) compared with other fields (8.3%, P = 0.037). Single-category device queries exhibited a higher reproducibility ratio than multicategory ones, but without statistical significance (27.1% versus 8.3%, P = 0.321). Studies including a data processing flow had a higher reproducibility ratio than those without, although this difference was not statistically significant (42.9% versus 17.4%, P = 0.107). Conclusions Our findings indicate that the reproducibility of queries in MAUDE data-driven studies is limited. Enhancing this requires the development of more effective MAUDE data query strategies and improved application programming interfaces.

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“…In spite of the potential benefits, the EBV placement procedure is associated with risk of complications, for example, pneumothorax that is seen in 4.2%–26.6% of the treated patients, 7 and not all patients achieve the expected outcome. 7 , 8 Moreover, patients are faced with the decision to receive EBV treatment at a point in their disease trajectory where there are only few remaining treatment options and an outlook toward worsening of life-limiting symptoms in the future. Healthcare providers play a significant role in patients’ decision-making process.…”

Section: Introductionmentioning

confidence: 99%

Endobronchial valve treatment in chronic obstructive pulmonary disease: A qualitative study of patients’ expectations

Farver-Vestergaard,

Mousing,

Løkke

et al. 2023

SAGE Open Medicine

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Objectives: Endobronchial valve (EBV) treatment is a treatment option for selected patients with severe chronic obstructive pulmonary disease (COPD) to reduce dyspnea and improve quality of life. However, the procedure is associated with risk of complications, and not all patients achieve the expected outcomes. The present study explores patients’ expectations while waiting for EBV treatment. Methods: Fifteen patients accepted for EBV treatment at Aarhus University Hospital in Denmark from October 2020 to June 2021 participated in a 30-min, semi-structured interview about (1) the experience of living with COPD and (2) expectations regarding EBV. Results: Four themes were identified: a life of reduced quality; hopes and expectations; information about EBV; and perception of risks. Most patients described their lives as not worth living, and they hoped that EBV would give them their physical and social lives back, while also being aware that EBV would probably not work miracles. Patients’ information seeking was influenced by their hopes and expectations to the treatment. They filtered out negative information, focusing on the hope for a positive outcome. This made them willing to run the risk of complications. Conclusion: Living a life of considerably reduced quality, patients might have an increased focus on potential positive effects of EBV treatment while filtering out information about potential side effects. This might bias their decision-making process.

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Complications of Endobronchial Valve Placement for Bronchoscopic Lung Volume Reduction

Cited by 7 publications

References 28 publications

Predictors of reoperation after lung volume reduction surgery

Predictors of reoperation after lung volume reduction surgery

Assessing the Reproducibility of Research Based on the Food and Drug Administration Manufacturer and User Facility Device Experience Data

Endobronchial valve treatment in chronic obstructive pulmonary disease: A qualitative study of patients’ expectations

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