title: Long-term follow-up after bronchoscopic lung volume reduction in patients with emphysema.
abstract: Bronchoscopic lung volume reduction (BLVR) is a novel emphysema therapy. We evaluated long-term outcome in patients with heterogeneous emphysema undergoing BLVR with one-way valves. 40 patients undergoing unilateral BLVR entered our study. Pre-operative mean forced expiratory volume in 1 s (FEV(1)) was 0.88 L · s(-1) (23%), total lung capacity was 7.45 L (121%), intrathoracic gas volume was 6 L (174%), residual volume (RV) was 5.2 L (232%), and the 6-min walk test (6MWT) was 286 m. All patients required supplemental oxygen; the Medical Research Council (MRC) dyspnoea score was 3.9. High-resolution computed tomography (HRCT) results were reviewed to assess the presence of interlobar fissures. 33 patients had a follow-up of >12 months (median 32 months). 37.5% of the patients had visible interlobar fissures. 40% of the patients died during follow-up. Three patients were transplanted and one underwent lung volume reduction surgery. Supplemental oxygen, FEV(1), RV, 6MWT and MRC score showed a statistically significant improvement (p ≤ 0.0001, p = 0.004, p = 0.03, p = 0.003 and p<0.0001, respectively). Patients with visible fissures had a functional advantage. BLVR is feasible and safe. Long-term sustained improvements can be achieved. HRCT-visible interlobar fissures are a favourable prognostic factor.
authors: Dept of Thoracic Surgery, University of Rome Sapienza, Policlinico Umberto I, Fondazione Eleonora Lorillard Spencer Cenci, Rome, Italy. federico.venuta@uniroma1.it
authors: Federico
authors: F
authors: Venuta
authors: Marco
authors: M
authors: Anile
authors: Daniele
authors: D
authors: Diso
authors: Carolina
authors: C
authors: Carillo
authors: Tiziano
authors: T
authors: De Giacomo
authors: Antonio
authors: A
authors: D'Andrilli
authors: Francesco
authors: F
authors: Fraioli
authors: Erino A
authors: EA
authors: Rendina
authors: Giorgio F
authors: GF
authors: Coloni
mesh_terms: D000328:Adult; D000368:Aged; D001999:Bronchoscopy / Q000379:methods; D004417:Dyspnea / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011013:Pneumonectomy / Q000379:methods*; D011446:Prospective Studies; D011656:Pulmonary Emphysema / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome