title: Endobronchial valves in treatment of persistent air leaks: a systematic review of clinical evidence.
abstract: BACKGROUND
  Persistent air leak is one of the most common complications of lung diseases and pulmonary resections. Prolonged hospitalization, increased morbidity, and increased overall treatment costs arise from persistent air leaks. The use of endobronchial valves (EBVs) in the management of air leaks is an important alternative, especially for patients who are not candidates for surgical treatment.
  
  
  METHODS
  We retrieved the included studies by performing a systematic search in PubMed and Scopus databases. The references of the included studies were also hand-searched.
  
  
  RESULTS
  We retrieved 25 case reports and 3 case series from our literature search. The most common cause of persisting air leaks was spontaneous secondary pneumothorax (12/39, 31%). The left upper lobe (13/39, 33%) and right upper lobe (14/39, 36%) were the most frequent locations of air leaks. Most air leaks treated with EBVs ceased in less than 24 h. Three recurrences of air leak were reported and 2 cases of EBV migration were described. No deaths were reported in correlation with EBVs.
  
  
  CONCLUSIONS
  EBVs are a minimally invasive therapeutical option that may be suitable for the treatment of persistent air leaks regardless of the initial cause, especially in high-risk patients. Nevertheless, studies with better methodological quality are essential to standardize this technique and to provide more evidence on EBV safety issues.
authors: Department of Thoracic Surgery, General Hospital of Attica "KAT", Athens, Greece.
authors: Ioannis D
authors: ID
authors: Gkegkes
authors: Department of Surgery, Korinthos General Hospital, Corinth, Greece.
authors: Sarantis
authors: S
authors: Mourtarakos
authors: Department of Thoracic Surgery, General Hospital of Attica "KAT", Athens, Greece.
authors: Ioannis
authors: I
authors: Gakidis
mesh_terms: D001980:Bronchi / Q000601:surgery*; D002908:Chronic Disease; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011030:Pneumothorax / Q000473:pathology* / Q000601:surgery*; D019736:Prostheses and Implants; D012008:Recurrence