Several clinical interests regarding lung volume reduction surgery for severe emphysema: meta-analysis and systematic review of randomized controlled trials

Huang, Wei; Wang, Wen R; Deng, Bo; Tan, You Q; Jiang, Guang Yi; Zhou, Hongwei; He, Yong

doi:10.1186/1749-8090-6-148

Cited by 18 publications

(14 citation statements)

References 33 publications

(74 reference statements)

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“…However, SL is often performed in older and retransplanted patients, who generally present with more comorbidities [11] . One of the main problems in SL is native lung hyperinflation [12,13] , but minimally invasive techniques such as video-assisted thoracoscopic surgery (VATS) [14] or bronchoscopic lung volume reduction [15,16] are now available and have shown good…”

Section: Introductionmentioning

confidence: 99%

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Borro¹,

Delgado²,

Coll³

et al. 2016

WJT

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AIM:To performed remains a subject of debate and is the principal aim of the study. METHODS:This retrospective analysis included 73 patients with emphysema (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012). The outcomes of patients undergoing single-lung transplantation (SL) (n = 40) or double-lung transplant (DL) (n = 33) were compared in a Cox multivariate analysis to study the impact of the technique, postoperative complications and acute and chronic rejection on survival rates. Patients were selected for inclusion in the waiting list according to the International Society of Heart Lung Transplantation criteria. Pre and postoperative rehabilitation and prophylaxis, surgical technique and immunosuppressive treatment were similar in every patients. Lung transplantation waiting list information on a national level and retrospective data on emphysema patient survival transplanted in Spain during the study period, was obtained from the lung transplantation registry managed by the National Transplant Organization (ONT). RESULTS:Both groups were comparable in terms of gender and clinical characteristics. We found significant differences in the mean age between the groups, the DL patients being younger as expected from the inclusion criteria. Perioperative complications occurred in 27.6% SL vs 54% DL (P = 0.032). Excluding perioperative mortality, median survival was 65.3 mo for SL and 59.4 mo for DL (P = 0.96). Bronchiolitis obliterans and overall 5-year survival were similar in both groups. Bacterial Core tip: This is a retrospective and comparative study of 2 cohort of patients with advanced-stage emphysema who were performed uni or bilateral lung transplant. The results of this study support the realization of singlelung transplantation in most of the cases of emphysema because it is technically simpler, it has less risk of surgical sutures, and finally it has less immediate postoperative complications. Single and double lung transplantation has a similar long-term survival. Moreover, if a second transplant is needed in the long-term, the contralateral transplantation has the same initial transplant survival if the patient remains in a similar clinical situation. Survival Spanish national register does not show difference between the two techniques too, supporting the results of our relatively small series. This strategy of performing single lung transplantation in most of the cases of emphysema would encourage and enhance the use of donors thanks to the twining procedure, and would decrease mortality in the waiting list as shown in the National Transplant Organization patients analysed. Proper pre and postoperative prophylaxis and postoperative early extubation protocol is essential to achieve good results.Borro JM, Delgado M, Coll E, Pita S. Singlelung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality. World J Transplant 2016; 6(2): 347355 Available from:

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Section: Introductionmentioning

confidence: 99%

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Borro¹,

Delgado²,

Coll³

et al. 2016

WJT

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“…The United States FDA has approved the marketing of bovine pericardium as a dural graft material in 1996 [19]. It has been widely used for grafts in cardiac surgery [20], thoracic surgery [21], and neurosur- Values are means ± standard deviations. PSR, posterior scleral reinforcement; BCVA, best corrected visual acuity; hCRC, horizontal corneal radius of curvature; vCRC, vertical corneal radius of curvature.…”

Section: Discussionmentioning

confidence: 99%

Axial Length/Corneal Radius of Curvature Ratio Assessment of Posterior Sclera Reinforcement for Pathologic Myopia

Zhao

et al. 2017

Ophthalmologica

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Purpose: The aim of this study was to assess the axial length/corneal radius of curvature ratio changes after posterior scleral reinforcement (PSR) for pathologic myopia. Procedures: This study enrolled 32 pathologically myopic eyes treated with PSR and 35 untreated pathologically myopic eyes. Axial length, refractive error, best corrected visual acuity, corneal radius of curvature, and the axial length/corneal radius of curvature ratio were evaluated during the 1-year follow-up. Results: There were no statistical differences in each parameter between the 2 groups at baseline. Significant differences were found between the 2 groups in both axial elongation and best corrected visual acuity improvement. The average axial length/horizontal corneal radius of curvature ratio significantly decreased in the PSR group. Conclusion: The PSR surgery can effectively delay the axial elongation in pathological myopia. Axial length/horizontal corneal radius of curvature ratio significantly decreased, which may indicate less myopic progression after surgery.

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“…However, there has not been any indication in published studies that the surgical approach affects long-term functional outcomes. 43 Strengths of this study are that it has a relatively large group of unique subjects with data collected on both types of surgeries in a single NETT center with a single exercise lab and using the NETT protocols and rehabilitation guidelines throughout.…”

Section: Discussionmentioning

confidence: 99%

Ventilatory Efficiency Before and After Lung Volume Reduction Surgery

et al. 2014

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BACKGROUND: Lung volume reduction surgery (LVRS) has been shown to improve the clearance of carbon dioxide and minute ventilation (V E ) in select patients with COPD. One variable often assessed in COPD is ventilatory efficiency (V E /V CO 2 ). METHODS: We compared 55 LVRS subjects with 25 controls from the National Emphysema Treatment Trial. V E /V CO 2 was calculated from cardiopulmonary exercise testing at baseline and 6-months. We sought to assess V E /V CO 2 changes with LVRS compared with controls who only received standard medical care. RESULTS: At 6 months, the LVRS group significantly increased peak V O 2 , work load, V E , V CO 2 , and tidal volume while lowering peak and lowest V E /V CO 2 (improved ventilatory efficiency) and end-tidal carbon dioxide pressure. The control group did not display these changes. The changes were greatest in the LVRS subjects who improved their exercise capacity after surgery (> 10 W). CONCLUSIONS: The changes were greatest in the LVRS subjects who showed the most functional improvement, indicating an association of improved ventilation with improved functional outcome.

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Several clinical interests regarding lung volume reduction surgery for severe emphysema: meta-analysis and systematic review of randomized controlled trials

Cited by 18 publications

References 33 publications

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Single-lung transplantation in emphysema: Retrospective study analyzing survival and waiting list mortality

Axial Length/Corneal Radius of Curvature Ratio Assessment of Posterior Sclera Reinforcement for Pathologic Myopia

Ventilatory Efficiency Before and After Lung Volume Reduction Surgery

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