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Titolo:
Bronchoscopic volume reduction - A safe and effective alternative to surgical therapy for emphysema
Autore:
Ingenito, EP; Reilly, JJ; Mentzer, J; Swanson, SJ; Vin, R; Keuhn, H; Berger, RL; Hoffman, A;
Indirizzi:
Brigham & Womens Hosp, Pulm Crit Care Div, Dept Pulm & Crit Care Med, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 Care Med, Boston, MA 02115 USA Brigham & Womens Hosp, Dept Thorac Surg, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 orac Surg, Boston, MA 02115 USA Tufts Univ, Vet Facil, Grafton, MA USA Tufts Univ Grafton MA USATufts Univ, Vet Facil, Grafton, MA USA
Titolo Testata:
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
fascicolo: 2, volume: 164, anno: 2001,
pagine: 295 - 301
SICI:
1073-449X(20010715)164:2<295:BVR-AS>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
SURGERY; VENTILATION; IMPROVEMENT;
Keywords:
lung volume reduction therapy; emphysema; interventional bronchoscopy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Ingenito, EP Brigham & Womens Hosp, Pulm Crit Care Div, Dept Pulm & Crit Care Med, 75 Francis St, Boston, MA 02115 USA Brigham & Womens Hosp 75 Francis St Boston MA USA 02115 5 USA
Citazione:
E.P. Ingenito et al., "Bronchoscopic volume reduction - A safe and effective alternative to surgical therapy for emphysema", AM J R CRIT, 164(2), 2001, pp. 295-301

Abstract

Lung volume reduction surgery (LVRS), the removal of damaged, hyperexpanded lung, has been shown to improve respiratory function in many patients with end-stage emphysema. We report the results of an animal study using a newtransbronchoscopic alternative to LVRS in which a washout solution and fibrin-based glue are used to collapse, seal, and scar target regions of abnormal lung. Twelve sheep had static and dynamic lung functions measured at baseline. Emphysema was produced by inhaled papain (7,000 U/wk X 4 wk), resulting in a significant increase of lung volumes, compliance, and airway resistance. The animals were then divided into three treatment groups of four animals, and underwent surgical volume reduction (SVR), bronchoscopic volumereduction (BVR), or bronchoscopy alone (Sham-BVR). Response to each intervention was assessed 8 to 12 wk after treatment by measuring lung function and examining lung tissue. BVR and SVR groups responded with significant andsimilar decreases in TLC and residual volume (RV). Tissue examination demonstrated that BVR caused collapse of the lung with focal scarring in II of 20 target territories (55% success rate). Three of the II target zones developed sterile abscesses. Postprocedure complications were less frequent with BVR than with SVR. This pilot study suggests that lung volume reduction can be achieved in animals without surgery using a bronchoscopic approach and a novel fibrin-based glue system. BVR has the potential for simplifying volume reduction, extending indications, and reducing morbidity, mortality, and costs in humans.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 15:24:53